HealthInfo Waitaha Canterbury
Treating broken elbows in children
Ka pēhea ngā tuke tāwhatiwhati e whakarauora ki ngā tamariki?
Treatment for a broken elbow depends on exactly where the break is and how much the bones have moved apart (displacement). If the break is simple and uncomplicated, your tamaiti (child) may just need a cast on their arm while it heals.
If the pieces of bone are very out of place your tamaiti might need surgery. If your tamaiti has damaged nerves, blood vessels or ligaments in their elbow, these may need to be treated as well.
If the elbow heals in the wrong position, it may remain permanently crooked and your tamaiti may have limited movement in that arm.
Treatment without surgery
If your child's bones are still in the normal position, they usually heal successfully with a cast or splint that holds them in the right position (immobilisation).
Splints give less support than casts, but they're easy to adjust to make room for any swelling caused by the injury. Often the arm is put in a splint first, then a cast is fitted once the swelling goes down.
Sometimes the doctor may have to gently move the bones back into place before the splint or cast is fitted. This is called a closed reduction. If your tamaiti needs this, they will have some form of anaesthetic before this happens.
As your tamaiti heals, they may have some X-rays to make sure the bones are staying in place.
Surgery
If the pieces of bone have moved apart, your tamaiti may need surgery. There are two different operations.
Closed reduction and percutaneous pinning
In this operation, the surgeon moves the pieces of bone into the right place without making any big cuts in the skin, then inserts metal pins to hold them there. The pins are put in through the skin, into the bone and across the fracture. Usually, the surgeon makes a very small cut (less than 5 mm) to insert the pins and then closes this with stitches or steri-strips.
Your tamaiti will have a splint for the first week after their operation, and then probably a cast. A few weeks after surgery, the cast will be taken off and the pins removed.
Open reduction and internal fixation
Some injuries need an operation called "open reduction internal fixation" (often called ORIF). Open reduction means the surgeon needs to cut open the skin to move the bones. Internal fixation means the pins that hold the bones in place while they're healing are put in through this cut.
This operation is usually used for:
- injuries where the broken bone is sticking out through the skin (called open fractures)
- more complex breaks that a surgeon cannot move with a closed reduction
- breaks that have also injured the nerves or blood vessels.
Helping your child with a broken elbow
There are some things that you and your tamaiti can do to make sure they recover as quickly and well as possible.
- Your tamaiti should wear an arm sling for two to three weeks.
- In the first 24 to 48 hours, hold an ice pack against their elbow for 20 minutes at a time to decrease pain and swelling.
- Your tamaiti may need simple pain medication. Give it to them regularly, but never exceed the recommended dose.
- Encourage your tamaiti to move their shoulder, hand and fingers. Once the sling comes off, they can start gently moving their elbow.
- Your tamaiti may return to sports such as swimming as soon as they're comfortable. But they should avoid contact sports for six weeks after they stop using a sling.
Your doctor or nurse will tell you when they need to see your tamaiti again. Sometimes for straightforward breaks that are still in a normal position, your tamaiti may not need any follow-up.
Getting more help for a child with a broken elbow
While most breaks should heal, you should go back to your general practice team or the clinic your tamaiti was treated at if they have:
- continued tingling or a change in feeling in their arm or hand
- pain at the site of the break after six weeks.
On the next page: Common types of elbow fractures in children
Written by HealthInfo clinical advisers. Last reviewed March 2022.
SourcesReview key: HISAA-362960
