Over the years we have dealt with numerous broken bones and sprains with our daughter who has CAH.  I think it really depends on the child and the severity of the break.  We took each situation and handled it based on how she was faring at the time.  Generally we just stress dosed orally and got to the hospital.  If the breaks had been more severe, we probably would have administered the shot.  I can always look at my daughter and assess how she is doing.  Her color changes, she gets lethargic, she has a certain look around her eyes that tells me it’s time for a shot.  By the way, my daughter is a mild salt-waster.  I think the severity of the salt wasting probably plays into this as well.  All children are subject to injuries if they are active and into sports of any kind.  I would definitely recommend discussint this with the endocrinologist for all parents of a child with CAH and hav a plan ready in the event something like this happens.  Good luck all.