Elbow fractures are common injuries in children, accounting for around 10% of all childhood fractures. They involve a break in one or more of the bones that make up the elbow joint – the humerus (upper arm bone), radius, and ulna (forearm bones). The elbow is a complex joint with an intricate network of nerves, blood vessels, ligaments, and growth plates in children, making these fractures potentially complicated.

Common Symptoms

• Sudden, intense pain in the elbow and forearm
• Swelling around the elbow
• Bruising and discoloration
• Inability or reluctance to move the arm
• Deformity or misalignment of the elbow
• Numbness in the hand (potential nerve injury)

Cause & Anatomy

Elbow fractures in children commonly occur due to:

• Falls on an outstretched arm or directly on the elbow
• Direct blows or trauma to the elbow region
• Sports injuries or accidents during play/activities

The elbow joint contains multiple growth plates (areas of cartilage) in children, which can be affected by fractures and complicate diagnosis and treatment.

Diagnosis

• Physical examination to assess pain, swelling, deformity, range of motion, and neurovascular status
• X-rays to visualize the fracture type, displacement, and alignment
• Comparison X-rays of the opposite arm may be needed for comparison
• MRI or CT scans in some cases to better visualize cartilage

Prevention

• Encourage safe play and sports practices
• Ensure proper supervision during activities
• Use protective gear (elbow pads/guards) for high-impact sports

Treatment

Treatment depends on the fracture type, displacement, and the child’s age/overall health.

Nonsurgical Treatment:

• Casting or splinting to immobilize stable, non-displaced fractures
• Closed reduction (manipulation) under anesthesia to realign bones before casting

Surgical Treatment:

• Closed reduction and percutaneous pinning (inserting pins through the skin) for displaced fractures
• Open reduction and internal fixation (surgery) for open fractures, irreducible fractures, or those with neurovascular injuries

Surgery

Surgical treatment may be required for:

• Displaced fractures that cannot be properly realigned without surgery
• Open (compound) fractures where the bone protrudes through the skin
• Fractures accompanied by nerve or vascular (blood vessel) injuries
• Common surgical procedures include:
• Closed reduction and percutaneous pinning
• Open reduction and internal fixation with plates, screws, or wires

Rehabilitation

After treatment, rehabilitation may involve:

• Immobilization with a cast or splint for 3-6 weeks
• Physical therapy to restore range of motion and strength once healing begins
• Gradual return to activities and sports under professional guidance

FAQ’s

How long does it take for a child’s elbow fracture to heal?
Most children remain in a cast for 3-4 weeks following treatment. Healing typically takes 6-8 weeks, but can vary based on the fracture severity and the child’s age