When a child breaks a bone, it can be hard to spot on an X-ray

Q. My 12-year-old daughter was playing basketball last week, fell and banged her left elbow on the bleachers. Since she had significant pain and swelling, we brought her to urgent care. They took X-rays and said a break was not apparent but it was possible there was a fracture there anyway. My daughter was put in a splint and sling and told to see an orthopedic surgeon.

It seems like this was an overreaction to my daughter’s injury as the X-rays were negative. What do you think? Can I remove her splint and sling? When can my daughter return to basketball?

A. X-rays of adolescents and children often show that bone growth is still occurring. The areas on the end of the bones are known as growth plates.

On an X-ray, growth plates appear as black lines going through the ends of the bones. Fractures or breaks also appear as black lines going through the bone.

If a fracture of the bone occurs without displacement through the growth plate, the fracture may not be evident. I think your daughter received excellent treatment and advice from the urgent care, as she could have a fracture present and splinting and a sling help prevent a fracture from coming out of place.

She should see an orthopedic surgeon to establish the correct diagnosis. This will allow your daughter to return to sports as quickly and safely as possible.

Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send your questions to HarlanS@baptisthealth.net