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Fracture of the upper arm, shoulder, elbow and forearm

Conditions

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The most common arm fractures in children and young athletes involve the upper arm, shoulder, elbow and forearm.

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Patients can be seen by Texas Children's experts in Orthopedic Surgery.

Causes & Risk Factors

The injuries usually occur when a child falls on the arm in an awkward position. Broken bones, or fractures, are quite common and can happen while kids are playing or participating in sports.

Symptoms & Types

A broken or fractured bone in the arm usually has the following symptoms:

  • Arm or elbow pain
  • Swelling and focal tenderness
  • The arm may look deformed

Diagnosis & Tests

After discussing your child's medical history and how the injury occurred, your doctor will do a thorough examination. The doctor will look for:

  • Swelling and tenderness
  • Bruising
  • A deformed or crooked appearance of the injured part of the arm
  • Tears or openings in the skin

If the doctor suspects the child has a broken arm, he will order additional tests:

  • X-rays: The most common way to evaluate a fracture is with x-rays. An x-ray takes a picture of the child’s arm and can show whether a bone is broken or not.
  • Magnetic Resonance Imaging (MRI) and Computed Tomography (CT): These diagnostic tools usually are not needed for these fractures.

Treatment & Care

Your doctor will make sure the bones heal in proper position.  Sometimes this will require manipulation or surgery. 

Nonoperative (non-surgical): The doctor will perform closed reduction (putting the pieces of bone back together so they can grow back together as one bone) and immobilize the arm, usually with a cast.

Surgery: For more serious injuries, your doctor may recommend surgery. Your child will be given anesthesia to sleep during the surgery so he won’t feel anything. Surgery can involve inserting metal pins in the bone to hold it in a good position during healing.  

Living & Managing

Nonoperative follow up generally includes close monitoring of the arm in its cast with x-rays for the first 3-4 weeks following reduction. The cast will remain on the arm for between 4 and 12 weeks depending on the bone and the age of the child.

Surgical:  Once the bone has healed after surgery, the doctor will usually remove the pins from the arm.

Broken bones in children heal at different rates. How quickly depends on the child’s age and what type of fracture occurred. For example, breaks in young children may heal in as little as 3 weeks. Teenagers, by contrast, may take 6 weeks for the same kind of fracture to heal.

It's important for your child to wait to play games or sports that might use the injured part until the doctor says it is safe.

References & Sources

American Academy of Orthopaedic Surgeons. “Elbow Fractures in Children”: http://orthoinfo.aaos.org/topic.cfm?topic=A00037