Elbow Fracture in Children
The elbow is made up of three bones—the upper arm bone (humerus)and the two forearm bones (radiusand ulna). An elbow fracture is a break in one of these bones. Elbow fractures in children often include the lower and upper parts of the arm bone.
With proper treatment elbow fractures often heal without complications. However, sometimes complications do occur, such as:
- An injury to the artery in the upper arm (brachial artery injury). This is the most common complication.
- Growth plate disruption. This can cause the bone to grow abnormally.
- A deformity called cubitus varus. This happens if the bone heals in a poor position. It can be prevented with proper treatment.
- Nerve injuries. These usually get better and rarely result in any disability. They are more likely to happen with fractures where the broken bone moves completely out of position.
- Compartment syndrome. This is a rare condition that occurs if the fracture is treated too soon. Compartment syndrome may cause a tense forearm and severe pain. It is more likely to happen with fractures where the broken bone moves completely out of position.
What are the causes?
This condition may be caused by:
- Falling on an outstretched arm.
- Falling on the elbow from a height, like from playground equipment.
- A direct hit to the arm. This can happen in contact sports like football.
What are the signs or symptoms?
Symptoms of this condition include:
- Severe pain in the elbow or forearm.
- Swelling, bruising, and tenderness around the elbow.
- A change in shape of the arm, elbow, or forearm.
- Inability to move the elbow, especially to a straight position.
- Numbness in the hand.
How is this diagnosed?
This condition is diagnosed with:
- A physical exam.
- An X-ray.
How is this treated?
Treatment for this condition depends on the position of the broken bones:
- When the bones are close to their normal position, the elbow will be held in place (immobilized) with a splint or cast until the bones heal. If there is a lot of swelling, a splint may be used first and then replaced with a cast when swelling gets better.
- When the bones have moved out of place, your child’s health care provider will reposition them with or without surgery (closed or open reduction).In some cases, the bones may need to be stabilized with screws, plates, or wires. Once your child’s bones are back in their proper position, your child will get a splint or cast.
Follow these instructions at home:
Managing pain, stiffness, and swelling
- If
directed, put ice on the injured area.
- If your child has a removable splint or immobilizer, remove it as told by your child’s health care provider.
- Put ice in a plastic bag.
- Place a towel between your child’s skin and the bag.
- Leave the ice on for 20 minutes, 4 times per day, for the first 2 to 3 days.
- Have your child gently move his or her fingers often to avoid stiffness and to lessen swelling.
- Have your child raise (elevate) the injured area above the level of his or her heart while he or she is sitting or lying down.
If your child has a splint or immobilizer:
- Have your child wear the splint or immobilizer as told by his or her health care provider. Remove it only as told by the health care provider.
- Loosen the splint or immobilizer if your child’s fingers tingle, become numb, or turn cold and blue.
- Keep the splint or immobilizer clean.
- If
the splint or immobilizer is not waterproof:
- Do not let it get wet.
- Cover it with a watertight covering when your child takes a bath or a shower.
If your child has a cast:
- Do notallow your child to stick anything inside the cast to scratch the skin. Doing that increases the risk of infection.
- Check the skin around the cast every day. Tell your child’s health care provider about any concerns.
- You may put lotion on dry skin around the edges of the cast. Do notput lotion on the skin underneath the cast.
- Keep the cast clean.
- If
the cast is not waterproof:
- Do notlet it get wet.
- Cover it with a watertight covering when your child takes a bath or a shower.
General instructions
- Carefully monitor the condition of your child’s arm.
- Have your child do range of motion exercises if directed by your child’s health care provider.
- Give over-the-counter and prescription medicines only as told by your child’s health care provider.
- Keep all follow-up visits as told by your child’s health care provider. This is important.
Contact a health care provider if:
- There is more swelling or pain in your child’s elbow.
Get help right away if:
- Your child begins to lose feeling in his or her hand or fingers.
- Your child’s hand or fingers swell or become cold, numb, or blue.
Summary
- Elbow fractures in children often occur as a result of a fall or sports injury.
- Treatment depends on the severity of the injury and may include wearing a cast or splint to protect and support the bones as they heal.
