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Catching His Second Chance: Ethan’s Triumph Over Elbow Injury

Catching His Second Chance: Ethan’s Triumph Over Elbow Injury

by | Jul 2, 2025 | Fractures, Sports Medicine

Ethan, of Richardson, Texas, has a deep passion for sports, especially baseball. As a dedicated catcher, the 11-year-old transforms into the reputable “Monster,” a nickname he earned for his fearless and determined presence behind the plate.

“The nickname ‘Monster’ just stuck with his teammates,” says Erin, Ethan’s mother. “To me, Ethan is sometimes serious, sometimes a goofball and plays for the love of the game.”

After practicing throwing with his friends, Ethan’s passion for baseball was tested when he felt pain in the inner part of his right elbow. Their pediatrician referred Ethan and his family to Scottish Rite for Children Orthopedic and Sports Medicine Center in Frisco for care.

“His injury is one of the most common areas of pain for baseball players,” says sports medicine physician Jacob C. Jones, M.D., RMSK. “Since Ethan is not skeletally mature and is still growing, it was important to consider the different potential diagnoses than those typically seen in adults.”

While Ethan’s X-ray showed no sign of injury, Dr. Jones used ultrasound technology, which detects injuries that might not appear on a standard X-ray. It revealed Ethan’s diagnosis was a subapophyseal avulsion fracture of his inner elbow. This injury occurs when a small piece of bone attached to the ligament is pulled away from the main part of the bone.

“It was a radiographically hidden fracture since it was not seen on the kind of imaging we normally use to look for fractures,” Dr. Jones says. “Because of the ultrasound, we were able to give Ethan the correct diagnosis.”

To help his small fracture heal, Ethan wore a cast for a month. The ultrasound technology would also confirm that Ethan’s fracture had healed, allowing him to begin physical therapy. His sessions with physical therapist Kristyn Morrison at Scottish Rite for Children at The Star in Frisco focused on regaining the full range of motion in his elbow through various exercises, such as elbow extensions and forearm stretches. Once his strength was at an ideal level, Ethan began Scottish Rite’s Throwing Program — a patient education guide that focuses on baseball-specific strengthening exercises needed to gradually return to the sport.

After a month, Ethan officially completed all of his physical therapy sessions and uses the exercises he learned from his sessions and the Throwing Program to continue throwing pain free. Now, Ethan is back on the field with his teammates, knocking his recovery out of the park!

“At Scottish Rite, you can feel the care when you walk in,” Erin says. “You’re not a number or a piece of paper. Your child is treated like an individual, and I attribute the fact that my son can play his sport to the care he received at Scottish Rite.”

Jammed Finger? Early Treatment Can Improve Outcomes

Jammed Finger? Early Treatment Can Improve Outcomes

by | Mar 31, 2025 | Fractures, Sports Medicine, Therapy Services

When an injury occurs to a young athlete’s bones, ligaments and muscles in their hand, an evaluation is needed. A properly treated hand injury will most likely heal without complications.

In basketball and volleyball, fingers are at an increased risk of injury due to a variety of causes. Some children may snag their finger on a jersey, or others may hang on the rim or net. When an athlete says they have “jammed” their finger, there is concern for a volar plate injury.

What is the volar plate?

The volar plate is a thick ligament, located on the palm side of the finger. It connects two bones in the finger and stabilizes the middle joint of the finger, known as the proximal interphalangeal, which prevents the finger from bending backwards.

What is a volar plate injury?

A volar plate injury occurs when the finger is hyperextended or bent backwards, damaging the ligament. It is also commonly known as a sprained or jammed finger.

In some cases, the volar plate can be stretched and torn, pulling off a small piece of bone. This results in a fracture in the area called an avulsion fracture. With severe injuries, the joint may also be dislocated.

What are the symptoms in the injured finger?

  • Bruising
  • Immediate pain in the middle joint
  • Swelling of the middle joint
  • Decreased range of motion

What is the treatment for a volar plate injury?

Fracture Clinic provider Gerad Montgomery, M.S.N., FNP-C, sees and treats volar plate injuries frequently at Scottish Rite for Children Orthopedics and Sports Medicine Center in Frisco. “Treatment for a volar plate injury depends on the severity and can range from a short period of immobilization to surgery,” Gerad says.

With more than 15 years in providing pediatric orthopedic care, Montgomery has learned to warn families of the risks associated with not properly treating this injury. It’s important for families and young athletes to understand that volar plate injuries can worsen to the point of needing surgery without evaluation or treatment from an expert.

When should an athlete return to sports after a volar plate injury?

After a clinical provider has released the athlete to begin exercises, gentle range of motion progressing to strengthening exercises may be recommended. Some athletes may need guided exercise with an occupational therapist. “Before returning to sports, the hand and finger should have full strength and range of motion,” certified hand therapist Lindsey Williams says. “Otherwise, there is a risk of injury to the same or other joints nearby.”

Not sure what to do if your child gets a finger injury? Learn about our Fracture Clinic and Sports Medicine Clinic.

Childhood Fractures: What You Need to Know

Childhood Fractures: What You Need to Know

by | Mar 13, 2025 | Fractures

The human skeleton takes decades to fully mature. Until then, a child’s bones differ from an adult in several ways. Like young tree branches, which bend before they snap, a child’s softer and more flexible bones are less likely to break clean through. Instead, they often crack on one side, while the other side remains intact.

A greenstick fracture is a type of bone fracture, or broken bone, that is found in children typically under the age of 10. It occurs when the bone bends enough to crack on one side, like a tree branch under pressure. Greenstick fractures get their name from the way they resemble a broken twig in X-ray imaging.

A Common Childhood Injury

When young children fall as they play and explore, they tend to cushion their falls with their arm. This leads to forearm, wrist fractures, and greenstick fractures, among other injuries. When a greenstick fracture occurs, the most common reason is because a child was trying to stop a fall. Most greenstick fractures occur in children younger than 10, since their bones are still flexible and softer. They typically affect long bones, including those located in the arm.

Recognizing the Signs of a Greenstick Fracture

If your child experiences a greenstick fracture, they might tell you the affected body part hurts, especially if you touch it. However, pain isn’t the only symptom associated with greenstick fractures. Additional symptoms may include:

  • Bruising
  • Swelling
  • Tenderness
  • Deformity in the injured area, such as crookedness in the arm
  • Reduced range of motion or willingness to move the injured area

Diagnosis and Treatment

It is important to seek medical treatment for your child, if you suspect they might have a fracture. A pediatric orthopedic specialist will ask questions about how the injury occurred and what symptoms your child is experiencing.

Scottish Rite for Children treats patients with suspected and confirmed fractures. Our Fracture Clinic offers walk-in and scheduled appointments.

Your pediatric orthopedic specialist will look for signs of a fracture. This includes gently touching the injured area or asking your child to move it to check for pain and limited range of motion. Your child may get an X-ray, so the orthopedic specialist can confirm whether the injury is a greenstick fracture or another type of injury.

If a fracture is confirmed, your child will need to rest their arm to allow the bone to heal. The pediatric orthopedic specialist may require them to wear a cast, or a splint in some cases. Typically, greenstick fractures take approximately six weeks to heal, which will allow the cast to be removed.

Children’s vs. Adults’ Bones: How Fractures Differ by Age

Although it is uncommon, adults can experience greenstick fractures. However, the main reason that adults don’t is due to how bones change with age.

Children have growth plates made of flexible cartilage at the end of their bones. Bones continue to develop and reach their full density by a person’s mid-20s, becoming stiffer than they were in childhood. As a result, fractures in adults tend to be more severe.

Both children and adults can experience complete fractures, which is when the bone breaks completely. However, a child’s bone is more likely to bend before breaking, while an adult’s bone is more likely to break outright.

Treatment is also more complex in adults. There are additional risk factors that are more commonly found in adults, such as higher body weights. Bone-weakening conditions, such as osteoporosis, can increase an adult’s risk to fractures.

 

Want to know where to go if your child experiences a broken bone? If your child has a confirmed fracture after visiting an urgent care or emergency room, please bring your child’s X-rays to Scottish Rite for Children’s Fracture Clinic for help. For suspected fractures, call 469-515-7200 to schedule an appointment at the Fracture Clinic.  

Broken Toe? Treatments Can Help These Small Bones Heal

Broken Toe? Treatments Can Help These Small Bones Heal

by | Oct 30, 2023 | Fractures

Broken toes are a common injury among children, who frequently stub their toes, drop heavy objects on them or close them in doors or cabinets. If your child breaks a toe, you, like many people, may assume nothing can be done. That’s a common misconception. Your child’s provider has many options for treating broken toes, and treatment is less complex than you may think.

Broken toe treatment can reduce your child’s pain and help them get back to being a kid.

Signs Your Child’s Toe May Be Broken

Each toe consists of two or three bones, as well as toe joints. Broken toes can range in severity from small hairline toe fractures to multiple breaks in a bone. 

Symptoms of a broken toe include: 

·       A crooked toe or toe that appears to be out of place 

·       Bruising and swelling, which may appear the day after the injury

·       Difficulty walking

·       Pain at the specific area of injury, also known as pinpoint pain 

·       Stiffness 

If you suspect your child has a broken toe, visit your child’s pediatrician or an urgent care clinic. Visit an emergency room if your child has an open fracture, in which bone has broken through the skin. Open fractures can become infected and need immediate care.

Often, health care providers can diagnose a broken toe with a physical exam. Your child’s provider may order an X-ray to find the exact location of the break and determine whether the toe is dislocated.

How to Treat a Broken Toe

Broken big toes and severe fractures may require casting and, rarely, surgery. However, most broken toes will heal with at-home care or basic medical treatments. Your child’s provider will likely recommend one of the following:

·       Rest. Your child will need to avoid putting unnecessary weight on the injured toe. Elevating the foot on a pillow can help with swelling.

·       Ice. Ice packs can also reduce swelling when placed on a broken toe for 10 to 20 minutes every one to two hours. Apply ice for three days or until the toe is no longer swollen.

·       Over-the-counter pain relievers. Acetaminophen (Tylenol®) and ibuprofen (Advil® or Motrin®) can reduce pain but follow dosing instructions closely. Do not give children aspirin unless their provider says it’s OK. Aspirin can increase the risk of Reye syndrome. 

·       Proper footwear. If your child needs to wear shoes, have them choose a wide, stiff-bottomed shoe that doesn’t put pressure on the injured toe but also keeps it in proper alignment. Depending on the extent of the fracture, your child’s provider may recommend a special boot while the toe heals.

·       Splinting. Your child’s provider may recommend a toe splint to hold the broken toe in place as it heals.

·       Taping. A common treatment known as buddy taping involves taping the injured toe to the healthy toe next to it. It’s not always helpful, so ask your provider first. The provider can also show you how to tape the toe properly.

Children shouldn’t walk on the toe until they can put pressure on it without feeling a lot of pain. Also, attend follow-up visits if you have them. Your child’s provider will examine the toe to ensure it is healing properly. 

Broken toes may need six to eight weeks to heal, according to the American Academy of Orthopaedic Surgeons, so be patient. 

Call your child’s provider if your child has any of these symptoms as the toe heals: 

·       Fever or chills, which could be signs of an infection

·       Tingling or numbness in the toe

·       Pain or swelling that gets worse, not better

·       Red streaks appearing on the foot or toe

Can a Broken Toe Heal on Its Own?

Broken toes can heal on their own, but treatment helps ensure better outcomes. Left untreated, broken toes may heal crooked, your child could develop chronic foot pain or he or she may have problems walking. 

Broken Toe vs. Stress Fracture

Active children and children who play sports may think they have a broken toe when they actually have an overuse injury. Activities that involve repetitive motions, such as running, or place significant force on the feet, such as basketball, can cause stress fractures, a type of overuse injury in which small cracks or painful bruising develop in the bones.

The ball of the foot has two small bones called sesamoids located below the big toe joint. Overuse can lead to a sesamoid stress fracture, which can cause pain and swelling near the base of the big toe. A sports medicine specialist can diagnose and treat these stress fractures and help your child prevent another overuse injury.

If you’ve visited an urgent care or emergency room and your child has a confirmed fracture, bring your child’s X-rays to our walk-in Fracture Clinic for help. The clinic is located at 5700 Dallas Parkway in Frisco and open from 7:30 – 9:30 a.m., Monday through Friday. For suspected fractures, schedule an appointment by calling 469-515-7200. 

Waterproof Cast 101

Waterproof Cast 101

by | May 30, 2023 | Fractures

Casts are made of two layers — a soft inner layer and a hard outer layer. The inner layer of a waterproof cast uses a special type of lining that allows it to get wet when bathing, showering or swimming.

Does a waterproof cast have any risks?
Every time a waterproof cast gets wet, it needs to completely dry. If the skin inside the cast stays wet for a long period of time, it can become irritated. If your child develops a rash or burning sensation while in the cast, notify your clinic immediately.

Waterproof cast care

  • A waterproof cast needs to get wet daily.
  • After your cast gets wet, make sure all of the water exits the cast by moving your arm/leg around.
    • Your natural body heat will evaporate the rest of the water in the cast.
    • You may also use a hair dryer, on the cool setting, to finish the drying process in areas like the elbow crease or heel of the foot.
  • Following bathing and swimming, flush the inside and outside of the cast with a forceful stream of clean water only.
  • If the cast gets itchy, dirty or smelly, you may rinse mild soap through the cast and then thoroughly flush it with clean water.

What else should I know about caring for a child in a waterproof cast?

  • Follow directions and activity restrictions given by your provider.
  • See cast care patient education for more information.
  • You may swim in lakes and oceans with the waterproof cast, but it can be difficult to remove sand, dirt and other small particles from inside the cast. If particles are left in the cast, they can cause skin irritation and discomfort. Please be sure to flush the cast thoroughly with clean water until all particles are removed before allowing the cast to dry.

Learn more about our Fracture Clinic.

Six Ways to Prevent Toddler Fractures

Six Ways to Prevent Toddler Fractures

by | Feb 9, 2023 | Fractures

According to Gerad Montgomery M.S., F.N.P.-C. from our Fracture Clinic, toddlers are naturally at an increased risk for certain fractures and other injuries. This is because they are in a phase of rapid growth, very active and very unsteady when walking. Toddler’s bones are soft and will often break or buckle with seemingly harmless injuries. He tells us that many injuries that cause a sprain or strain in an adult will cause a fracture in a toddler. The good news, for patients like 22-month-old Kye, is that these injuries generally are stable and do not require casts or splints for very long, if at all.

Here are some common toddler injuries we see in our Fracture Clinic:

Toddler’s fracture is a small break in the bone of the lower leg usually caused by a simple fall or a twisting injury. A common way these injuries occur is when a child’s foot is caught on a playground slide while going down the slide with a parent.

Nursemaid’s elbow occurs with a sudden forceful pull on an outstretched arm. This may happen when someone picks up the child or swings him or her by the arms. With this problem, the child often refuses to use the arm and holds it in a flexed position.

Fingertip injuries occur in thousands of young children each year, and they typically wind up in an outpatient clinic or emergency room. These injuries often result from accidents with common items such as home and car doors, drawers or scissors.

Broken bones from falls and collisions occur when playing with larger, stronger and faster kids or on equipment that is not age-appropriate.

Lessons to Learn:

  • Do not pick up or tug on your child while holding only his or her hands or wrists; this can put stress on the elbow.
  • Do not swing your child around when holding only their hands or wrists.
  • Toddlers should use age-appropriate playground equipment and slides.
  • Toddlers should ride down a playground slide alone.
  • Watch your toddler closely when climbing or playing with bigger kids.
  • Doors, drawers and sharp objects are not toys and young children should not play with them.

As experts in managing fractures and other injuries in growing bones, we are here for you when you need us. Learn more about our Fracture Clinic