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Open Reduction And Internal Fixation Of An Elbow Fracture In Children


  • Open reduction and internal fixation (ORIF) of an elbow fracture is surgery to repair a broken elbow. The broken elbow may be a break in one or more of the bones in your child's elbow. The elbow is the joint where the upper arm bone (humerus) meets the two lower arm bones (radius and ulna). The elbow joint helps greatly with arm movements. A fall on an outstretched hand, in an attempt to stop a fall, often causes an elbow fracture. This may also happen by falling directly on a bent elbow. Your child's elbow may be broken while playing sports. Broken elbows may occur because of a direct blow or if the elbow is hit straight on.
    Anatomy of the Arm
  • Open reduction and internal fixation is done if the elbow fracture is bad, or happened in several places. It may also be done if blood vessels and nerves were also damaged. A failed attempt to repair the elbow fracture without open surgery may also need an ORIF. During this surgery, your child's caregiver will make an incision (cut) over the broken bone. He may need to use drills, wires, screws, plates, and pins to align the broken bones and hold them together. Your child may need a cast or splint after his surgery. With an ORIF, your child's elbow fracture may be treated and he may resume his normal activities.



  • Keep a current list of your child's medicines: Include the amounts, and when, how, and why they are taken. Bring the list and the medicines in their containers to follow-up visits. Carry your child's medicine list with you in case of an emergency. Throw away old medicine lists. Give vitamins, herbs, or food supplements only as directed.
  • Give your child's medicine as directed: Call your child's primary healthcare provider if you think the medicine is not working as expected. Tell him if your child is allergic to any medicine. Ask before you change or stop giving your child his medicines.
  • Do not give aspirin to children under 18 years of age: Your child could develop Reye syndrome if he takes aspirin. Reye syndrome can cause life-threatening brain and liver damage. Check your child's medicine labels for aspirin, salicylates, or oil of wintergreen.
  • Antibiotics: This medicine is given to fight an infection caused by bacteria. Give your child this medicine exactly as ordered by his primary healthcare provider. Do not stop giving your child the antibiotics unless directed by his primary healthcare provider. Never save antibiotics or give your child leftover antibiotics that were given to him for another illness.
  • Pain medicine: Your child may need medicine to take away or decrease pain. Know how often your child should get the medicine and how much. Watch for signs of pain in your child. Tell caregivers if his pain continues or gets worse. To prevent falls, stay with your child to help him get out of bed.

Ask for more information about where and when to take your child for follow-up visits:

For continuing care, treatments, or home services for your child, ask for information.

Caring for your child's cast, splint, or brace:

  • Check the skin around the cast, splint, or brace every day. You may put lotion on any red or sore areas.
  • Do not let your child push down or lean on any part of the cast, splint, or brace. It may break.
  • Do not let your child scratch the skin under the cast, splint, or brace by putting a sharp or pointed object down it.
  • If your child has a plaster cast, do not let it get wet. When he takes a bath or shower, cover the cast with a plastic bag that is taped closed at the top.
  • Let him move the fingers of his arm several times a day. This will decrease swelling and stiffness.
  • A sling may be used to support the arm as needed.


  • Your child has a fever.
  • Your child has chills, a cough, or feels weak and achy.
  • Your child is irritable and crying more than usual.
  • Your child's splint/cast feels tighter and you think his fingers are getting more swollen.
  • Your child's skin is itchy, swollen, or has a rash.
  • There is a bad smell from your child's splint/cast.
  • You have any questions or concerns about your child's surgery, medicine, or care.


  • Your child's fingers look pale or blue, and feel cold, numb or tingly.
  • Your child's splint/cast becomes soaked with blood.
  • Your child's cast breaks.
  • Your child's has trouble breathing all of a sudden.

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.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Learn more about Open Reduction And Internal Fixation Of An Elbow Fracture In Children (Aftercare Instructions)

Micromedex® Care Notes