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What is an elbow fracture? — An elbow fracture is a break in 1 of the bones near the elbow. A "fracture" is another word for a broken bone. The elbow is a joint made up of three bones (figure 1):
●The humerus – The humerus is the bone that runs from the shoulder to the elbow.
●The radius – The radius is 1 of the bones in the forearm, the part of the arm between the elbow and the wrist. It is on the thumb side of the forearm when the palm is facing up.
●Ulna – The ulna is the other bone in the forearm. It is on the "pinky side" of the forearm when the palm is facing up.
In children, most elbow fractures happen:
●Above the elbow in the humerus
●At the knob of the elbow at the end of the humerus
What causes elbow fractures in children? — In children 3 years old or younger, most elbow fractures happen because of a fall from a bed or couch. In older children, most elbow fractures happen because of a fall off the monkey bars or a playground swing.
What are the symptoms of an elbow fracture? — The symptoms include pain, swelling, and tenderness around the elbow. Most children who have a broken elbow are also unable to move the injured elbow. Plus, many children who have broken a bone remember feeling a pop, crack, or snap when the injury happened.
If you think your child has broken an elbow, see a doctor or nurse right away.
Call for an ambulance (in the US and Canada, call 9-1-1) if your child:
●Has severe pain
●Has a very crooked-looking arm
●Has any bones sticking out through the skin
Will my child need tests? — Yes. Your child's doctor or nurse will ask about their symptoms, do an exam, and take an X-ray. During the exam, the doctor or nurse will look at and feel the injured elbow and check the pulse in the wrist. They will also ask your child to do some simple finger movements, such as pinching something, spreading the fingers, or giving a "thumbs up." This can show if the fracture caused any nerve damage.
How is elbow fracture treated? — The treatment depends on the type of fracture your child has and how serious it is.
If your child breaks an elbow, they will likely get medicine to help with pain. This might include ibuprofen (sample brand names: Advil, Motrin) or stronger medicines such as morphine or fentanyl. If your child gets morphine, it will need to go into their vein through a small tube called an "IV." If your child gets fentanyl, it might be given as a nose spray or through an IV.
If the ends of the broken bones are not far apart, the doctor will probably give your child a splint or cast, and a sling (a large bandage that hangs from the back of the neck and supports the arm). This will keep the arm from moving while the bone heals. This kind of treatment often does not require an orthopedic surgeon (a doctor who is also a bone specialist).
If the ends of the broken bones are far apart, an orthopedic surgeon will need to move them back into place. Often, they will need to do surgery to move the bones, but not always. Once the bones are in place, the surgeon might use pins, screws, or wires to keep them from moving.
After your child's elbow fracture is treated, they will also need to see an orthopedic surgeon regularly until the elbow fully heals. During these visits, the orthopedic surgeon will decide how long your child should wear a splint or cast. They will also take X-rays to make sure the bones are lined up correctly and healing well.
When should I call my child's doctor or nurse? — You should call the doctor or nurse if any of these symptoms occur after your child's fracture has been treated:
●The elbow gets very swollen.
●Purple spots appear near the elbow.
●Pain in the forearm gets worse.
●Pain gets worse when the child stretches out their fingers.
●The hand gets cold and pale.
These symptoms could mean the arm muscles and nerves have been damaged. If this happens, your child will need to have their cast taken off (if they are wearing a cast). The doctor will then follow your child's symptoms and decide whether they need more treatment.
Can elbow fractures be prevented? — Yes. Make sure your child only plays in playgrounds where there is at least 6 to 12 inches of soft surface (such as mulch, sand, or shredded rubber material) under the equipment. Also, make sure your child wears elbow guards when they are doing sports such as skateboarding.
Patient education: Caring for your child's cast (The Basics)
Patient education: Fractures (The Basics)
