Parents have been asking me some hard questions recently about how to tell if your child has fractured a bone on the athletic field. Let me break open some information on the subject of bones that fracture. If kids are going to break a bone while playing a sport, it is more likely to be the hand or arm because as kids fall they try to stop themselves with their hands, stressing the bones of the upper extremity and causing them to fracture or crack. How can you tell a fracture from a sprain or muscle strain? You cant tell 100 percent of the time, but usually fractures are associated with severe pain, swelling, and deformities of the arm or leg. With a fracture, you can often see that the bones are displaced. Other signs include hearing a snap at the time of injury, your child not wanting you to touch the affected body part, and certainly your child will not want to bear weight on it. If you suspect a fracture, seek medical care as soon as possible. If your child has an injury to the head, neck or back, or you see the bone coming through the skin, apply pressure with a cloth to stop the bleeding while you keep your child lying down until help arrives. Regardless of the apparent severity of the injury, its important to try to immobilize the area. Apply an ice pack or ice wrapped in cloth to reduce swelling, and, if possible, splint the extremity with something like a board or even a rolled-up newspaper that you can tape into place to prevent the bone from moving further, worsening the fracture. Usually your child will need an x-ray to confirm the fracture. If the x-ray does show a break, a pediatric bone specialist or orthopedic surgeon can decide whether casting or further surgery is needed to fix the break. Once a bone is broken, it can take anywhere from three-to-eight weeks to heal, depending on the age of the child. Younger children heal more quickly. Do not have your child play sports again until the injury has been re-examined and x-rayed again, to be sure it has fully healed. Of course, the best way to prevent fractures on the playing field is to make sure your child understands the rules of the game and wears the appropriate safety equipment. Hopefully, tips like this will cast the right light on gaining a better understanding of what to do if you are concerned that your child has broken a bone. Lewis First, M.D., is chief of Pediatrics at Vermont Childrens Hospital at Fletcher Allen and chair of the Department of Pediatrics at the University of Vermont College of Medicine. You can also catch First with Kids weekly on WOKO 98.9 FM and WCAX-TV Channel 3. Visit the First with Kids archives at www.vermontchildrens.org.