How An Elbow Fracture Occurs
One of the most common fractures that require surgery in the pediatric population is an elbow fracture. In fact, elbow fractures comprise up to 10% of all fractures in kids. An elbow fracture occurs when a child falls and hits the elbow directly or lands on an outstretched arm – causing the joint to hyperextend.
The elbow joint is composed of three bones: the humerus (upper arm bone), radius (forearm bone found on the thumb side), and ulna (forearm bone on the pinky side), which creates the tip of the elbow. The radius allows the forearm to rotate, and the ulna assists in bending and straightening the elbow. The surrounding ligaments and muscles, as well as their interlocking shapes, stabilize all three bones.
Any one of these bones can be fractured, although the end of the humerus is the most common site of an elbow fracture. When ligaments are torn and the bones move out of place, the joint can also be dislocated or subluxed (partially dislocated).
Some information to know about the elbow and children’s bones are:
- The elbow is a very active area of growth.
- In infants and toddlers, many of the elbow structures are not yet developed and are made of cartilage rather than bone.
- There are multiple growth plates in a child’s body—areas where new bone grows are typically located near the ends of long bones. In the elbow, these growth areas may look like fractures to the untrained eye.
- As children grow up, more of the bony architecture that is normally seen in adults becomes visualized on X-rays. Normal elbow X-rays look different at different ages due to bone growth and development. Pediatric orthopedic surgeons know what looks normal on a child’s X-ray at any given age range and are especially trained in how to look for and identify hidden or occult elbow fractures.
How To Treat A Fractured Elbow
Symptoms of an elbow fracture include significant pain, swelling, bruising, and decreased motion in the area. In some cases, other signs of a significant elbow injury are a visible deformity and neurologic/vascular dysfunction. A physical evaluation by an orthopedist is performed along with X-rays to diagnose a broken elbow. Depending on the findings, a CT scan or MRI may also be ordered.
How one treats an elbow fracture depends on the extent of the injury, the location of the fracture, and the stage of the child’s development. Both non-surgical treatments and operative treatments are determined by the orthopedic surgeon.
Usually, the pediatric orthopedist will splint the arm initially and recommend NSAIDs, elevation and icing to reduce inflammation. In accidents where the elbow fracture is hairline and non-displaced, treatment could include a sling, splint, or cast for a few weeks.
When the bone fragments are unacceptably misaligned and/or the joint disrupted, surgery may be necessary. Some injuries are treated emergently, especially if the fracture is very displaced, there is an open or impending skin wound, or there is possible nerve/vascular injury. The urgency and type of surgery depend on the bones affected and the particular injury patterns.
Most elbow fractures treated with or without surgery do well. Stiffness is the most common complication of fracture but can often be treated with time, stretching, and physical therapy. Growth disturbances, non-healing fractures, overgrowth, and arthritis are possible but are not as common.
The question parents and children ask us is, “How long does it take for a fractured elbow to heal?”. The answer is: it depends on the extent of the injury and the treatment for the fractured elbow. In most cases, children with elbow fractures will be immobilized for three to six weeks. Soreness may linger after that, but the elbow fracture should heal within that time as long as treatment instructions are followed. The pediatric orthopedist may recommend certain exercises to improve the range of motion.
Specialists in Pediatric Fractures
The Pediatric Orthopedic Center is a top-rated orthopedic center with locations in Cedar Knolls, Wayne, Jersey City & Springfield. We specialize in pediatric fractures, including elbow fractures and other acute orthopedic injuries. Learn more about our pediatric orthopedic practice on our website or book an appointment with our award-winning staff if your child is experiencing orthopedic issues.
