A Story of Hope, Healing and a Little Bookworm Named Aksel

Earlier this year, 6-year-old Aksel fractured his forearm while playing baseball.

“Playing is a strong word,” his mom, Maria, said jokingly. “His dad and I are athletes, so we signed Aksel up for baseball thinking it might be in the blood, but we have a little bookworm instead.” Every librarian within a 40-mile radius knows him by name and his favorite book.

Fractures of the forearm are the most common fractures in children. They often occur from a fall onto an outstretched hand, a direct blow or wheeled activities like biking or skateboarding. Fortunately, most pediatric forearm fractures can be treated without surgery because children's bones heal faster than adults, especially in children under 8, thanks to their high potential to remodel or reshape.

Aksel’s journey started at a local emergency room (ER). The ER team attempted a reduction – a process of realigning the bone – but it was unsuccessful. They placed his arm in a splint and referred him to Shriners Children’s New England for specialized care.

“At Aksel’s age, the acceptable angulation for a midshaft forearm fracture is less than 20 degrees,” said nurse practitioner Cameron Card, FNP. “It’s likely to remodel or straighten on its own as it heals, but Aksel’s was at 25 degrees, so intervention was recommended. If left untreated, it could have led to permanent deformity, decreased range of motion and impaired function.”

At Shriners Children’s, Cameron performed a closed reduction in the outpatient facility with assistance from athletic trainer Jon Reidy. This technique involved placing Aksel’s arm in a cast, applying direct pressure at the point of angulation and using counterpressure to realign the bone. It’s a delicate process, but one that can often prevent the need for surgery.

The outcome was exactly what everyone had hoped for. “If nothing more had been done after the ER visit, Aksel’s range of motion would’ve been at risk, and surgery would’ve been the next step,” said Cameron. “Instead, we were able to avoid surgery entirely.”

By July, follow-up X-rays showed Aksel’s bone was “pretty close to anatomically correct,” according to Cameron. Aksel wore a long-arm cast for four weeks before transitioning to a short-arm cast. Eventually, he only needed to wear a brace during high-activity play. He didn’t require physical therapy and was able to return to full use of his arm.

“Everyone at the ER was telling me to go to Shriners Children’s – the social workers, the nurses, even the parents on Aksel’s baseball team,” Maria said. “I’m not from here, so I had no idea. I was in a panic, but everyone said, ‘Go to Shriners Children’s.’ They were my beacon of hope.”

Maria was amazed at how quickly she was able to get an appointment. “I got in the very next day. It was magical. I’m so grateful. I sing Shriners’ praises to everyone.”

Aksel’s journey also offered a learning moment for Maria. “Everyone was concerned about his growth plates, but I had no idea what they were,” she said. “When Cameron explained that bones grow from the ends, not the middle, it was like an epiphany.” Fortunately, there’s no concern for Aksel’s growth plates.

“He’s good to go,” said Cameron. “He can read as many books as he wants.”

“Aksel’s not really into sports, but we read a lot. His arms are probably going to be a lot safer because of it,” Maria said jokingly.

Reflecting on the experience, Maria shared her gratitude. “Shriners Children’s took a horrible situation and made it as wonderful as it possibly could be,” she said. “I’m forever thankful.”