Elbow Fracture In Children

What is an elbow fracture?

An elbow fracture is a break in one or more of the bones that form your child's elbow joint. A joint is the area where bones meet. The elbow joint allows your child's arm to move. Your child's elbow joint is made up of 3 bones: humerus, radius, and ulna. Your child may also have a Salter-Harris fracture, which is when a bone breaks through a growth plate.

What causes an elbow fracture?

A fall onto an outstretched hand may cause an elbow fracture. It may also happen if your child falls directly on a bent elbow. Your child's elbow may be broken while he plays sports. A bad twist of the elbow and overuse of the elbow may also lead to fractures.

What are the types of elbow fracture?

• Non-displaced: A fracture is non-displaced when the bone cracks or breaks but stays in place.
  
  
• Displaced: A fracture is displaced when the 2 ends of the broken bone are separated.
  
  
• Comminuted: A fracture is comminuted when the bone cracks or breaks into many pieces.
  
  
• Open fracture: An open fracture occurs when the broken bone breaks through your child's skin.

What are the signs and symptoms of an elbow fracture?

• Pain and bruising.
  
  
• Swelling.
  
  
• Tenderness (pain when touched).
  
  
• Deformity (the arm is shaped differently than normal).
  
  
• Trouble moving the arm. Your child may not be able to move his arm at all.
  
  
• Weakness or numbness (loss of feeling) in the elbow, arm, or hand.
  
  
• Your child holds his elbow with his other hand to decrease pain.

How is an elbow fracture diagnosed?

Your child's caregiver will ask about your child's symptoms and medical history. He will check the skin over your child's injured elbow and arm for any skin breaks. He may touch areas of your child's arm to see if it has lost any feeling. He also may check for any problems with your child's arm movements. Your child's caregiver may put a shot of numbing medicine into your child's injured elbow joint before he checks the movement. Your child may need any of the following:

• X-rays: X-rays are pictures of your child's elbow to check for broken bones. Several pictures of your child's bones may be taken. Caregivers may take x-rays of your child's other elbow to compare with the injured one.
  
  
• Computed tomography scan: This test is also called a CT or CAT scan. This is a type of x-ray that uses a computer to take pictures of your child's arm and elbow. Your child may be given a dye before the pictures are taken to help caregivers see the pictures better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell your child's caregiver if your child is allergic to shellfish or has other allergies or medical conditions.
  
  
• Magnetic resonance imaging: This test is also called an MRI. Magnetic waves are used to take pictures of your child's elbow joint and arm. Your child will need to lie still during an MRI. Never enter an MRI room with any metal objects. This can cause serious injury.
  
  
• Bone scan: During this test, pictures are taken of your child's bones. Your child is given a small, safe amount of radioactive dye in an IV. Caregivers can look at the pictures for broken bones, infection, or cancer in the bones.

How is an elbow fracture treated?

Treatment may help decrease your child's symptoms. Treatment may also help your child return to his daily activities. Your child may need any of the following:

• Devices: A splint or cast with a sling may be put on your child's elbow and arm. These devices work to hold the broken bones in place. They may help decrease pain and prevent more damage to the broken bones.
  
  
• Medicines:
  
  
  • Pain medicine: Your child may be given medicine to take away or decrease his pain. Do not wait until the pain is severe before you give your child his medicine.
    
    
  • Antibiotics: This medicine will help fight or prevent an infection. Your child may need antibiotics if he has breaks in his skin. Make sure your child takes his antibiotics until they are gone, even if he feels better.
    
    
  • Tetanus shot: Your child may need a tetanus shot if he has breaks in his skin from the injury. A tetanus shot is medicine to prevent your child from getting tetanus. Tetanus is a serious infection that can happen after any break in your skin. The shot is normally given into the arm.
  
  
• Surgery: Your child may need surgery if his bones are out of place. Surgery helps return bones to their normal position by putting them together with pins, wires, or screws. Surgery may also be done if your child has other injuries, such as nerve or blood vessel damage. Ask your child's caregiver for more information about surgery to treat your child's elbow fracture.

What can I do to help my child's elbow fracture heal?

• Elevate your child's elbow: Use pillows to keep your child's elbow raised above the level of his heart as often as you can. This helps decrease swelling, and pain and improves blood flow. Elevation can also help the injury heal faster. While his elbow is elevated, have your child wiggle his fingers and open and close them to prevent hand stiffness.
  
  
• Ice: Use ice to help decrease swelling and pain. Put crushed ice in a plastic bag and cover it with a towel. Put the ice pack on your child's elbow for 15 to 20 minutes every hour. Use the ice for as long as directed.
  
  
• Physical therapy: Your child may need physical therapy. A physical therapist will help your child with exercises to improve the movement of his elbow joint and arm. The exercises can also help make your child's arm bones and muscles stronger.

What are the risks of an elbow fracture?

Your child may get an infection or bleed more than expected during surgery. Even after treatment, your child's elbow may not go back to the way it was before it was injured. Your child may have trouble going back to his usual activities, including sports. Without treatment, the injured elbow may heal in a crooked position. This may decrease how much your child can use his arm.

When should I contact my child's caregiver?

Contact your child's caregiver if:

• Your child has a fever.
  
  
• Your child's pain gets worse, even after he rests and takes his medicine.
  
  
• Your child has new or worse trouble moving his arm.
  
  
• Your child has new sores around the area of his brace or splint.
  
  
• Your child's brace or splint becomes damaged.
  
  
• You have questions or concerns about your child's injury, treatment, or care.

When should I seek immediate help?

Seek care immediately or call 911 if:

• Your child's elbow, arm, or fingers are numb.
  
  
• Your child's skin is swollen, cold, or pale (loses color).
  
  
• Your child has open skin areas on his elbow and arm that will not stop bleeding.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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