Summer safety: What to do if my child gets an elbow fracture

July 23, 2019
Elbow fracture | Texas Children's Hospital
Photo: Getty Images

Supracondylar Humerus Fracture  

Overview

We’re in full swing of summer break. This means your child is as active as ever—running, playing, climbing, jumping, and skipping indoors and out. When children are active, playing on the monkey bars, or jumping off play structures, they can accidently lose their balance and fall. If your child lands with enough force, a bone around the elbow can break.

A common injury children can sustain when falling on an outstretched arm is an elbow fracture. Elbow fractures account for about 10% of all childhood fractures. One of the most common elbow fractures is called a supracondylar humerus fracture. The typical mechanism of injury for this type of fracture is falling on a hyper extended arm. The fracture occurs in the arm bone (humerus) just above the elbow joint where the bone is the thinnest.

Anatomy

  • Humerus: the upper arm bone extending from the shoulder to the elbow
  • Radial head: this is the most proximal part of the radius, a bone in the forearm
  • Ulna: this is also a bone in the forearm, the most proximal part of this bone forms the hinge of the elbow and allows for bending and straightening

Symptoms

Most fractures result in a sudden, intense pain. Other common symptoms include:

  • Swelling
  • Inability to straighten the elbow
  • Bruising
  • Visible deformity  
  • Numbness and tingling in the hand or forearm, a sign of potential nerve injury

If any of these symptoms occur, the next step is to bring your child to an urgent care center or an emergency room where a health care provider can better assess your child.

Click here to schedule an appointment online.

Diagnosis

After discussing your child’s symptoms and medical history, the health care provider will perform a careful physical examination of your child’s arm. This will include evaluation of the elbow, as well as the upper arm and wrist to see if there are any other injuries. He or she will look for signs of:

  • Tenderness
  • Swelling
  • Bruising
  • Limited range of motion
  • Nerve and blood vessel function

Photo: Courtesy of NIH

The health care provider may also order an X-ray of your child’s arm. X-rays provide images of your child’s bones. An X-ray will indicate if and what type of fracture occurred.

Treatment

It is important to appropriately diagnose and treat supracondylar humerus fractures. If this type of fracture heals in the wrong position, the elbow may remain deformed or have limited range of motion. The most appropriate treatment is determined by the severity of the fracture. There are several ways a supracondylar humerus fracture can be treated. These options can be separated into two categories—nonsurgical and surgical treatment.

  • Nonsurgical treatment: If the bones are lined well, the health care provider may recommend nonsurgical treatment in a cast or a splint.
  • Surgical treatment: Some fractures are significantly displaced and require surgical intervention to ensure the fracture heals adequately. These procedures typically involve pins and casts which are removed around three weeks after the procedure in clinic.

Complications

In rare cases, complications of supracondylar humerus fractures can occur. These include:

  • Nerve injuries
  • Vascular injuries
  • Incorrect or incomplete bone healing                                                                                                                                                                          

Recovery

Fractures can take one to two months to heal. Your health care provider may require your child to come back in one week intervals to ensure the bones stay in place. As supracondylar humerus fractures approach full healing, the arm may be taken out of the cast. Your child will likely note elbow stiffness after the cast is removed. This is normal and expected to resolve over the coming weeks.

The best therapy for your child is to move his or her elbow and to continue normal daily activities.


References:

  1. https://eorthopod.com/elbow-anatomy/
  2. http://www.bonetalks.com/kidssupracondylar
  3.  http://orthokids.org/I-Broke-My/Pediatric-Elbow-Fractures
  4. https://orthoinfo.aaos.org/en/diseases--conditions/elbow-fractures-in-children
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2682409/
  6. https://www.sciencedirect.com/topics/medicine-and-dentistry/humeral-supracondylar-fracture

Post by:

Katherine B. Cavagnaro, MPAS, PA-C, Physician Assistant Fellow