Summer has a lot of injuries, which makes a nice change from cold and flu season, except of coarse for the patient. When should you take your kid to get an x-ray of their injury? General speaking; pin point pain is more likely a fracture whereas pain over an area is most likely not. Wrists are much more likely to be fractured then ankles. Twisted ankles nine times out of ten are not fractured, but pin point wrist pain 9 times out of ten is a fracture. If your child can walk on their twisted ankle it is most likely not broken. Twisted ankles hurt below the lateral malleolous, the bone on the outside of the ankle. Pain over the bone or further up the leg is more concerning for a fracture. Most sprains should be improving in 2-3 days, if they are not please come get an x-ray. I have seen recently dislocations and fractures that are 2 weeks old. It's much easier to treat those early on and cheaper to boot.
We treat fractures in the acute setting most of the time with a splint. We don't cast right away. Most of the time there is swelling within the first few days of the injury. The swelling needs to subside before a cast is placed.
The initial treatment for any injury should be ice and ibuprofen and compression if available. A fracture has to heel on its own, the cast is simply there to hold the bone in place while it repairs.