How Do You Care for an Elbow Fracture?
If your child has sustained a fracture, or broken bone, close to the elbow, they may need only a cast for the bone to heal. Or they may need to go to the operating room to have pins put in the bone to hold it in place while it heals.
If your child needs to have pins placed in the bone, a cast will be put on over the pins after the surgery. The pins will be removed at the doctor's office after the bone has healed.
Care
There may be some swelling of the hand and/or fingers for two to five days after the fracture. Keep the elbow and hand elevated above the level of the heart for the first two to te days by lying down on a couch or bed and propping the arm up with pillows.
Keeping an ice bag on the elbow will also help to reduce the swelling. Cover the bags of ice with a thin, dry towel to protect the cast from getting wet. If the swelling or pain increases, or fingers become numb, call the orthopaedic nurse or doctor.
Check your child's fingers daily for movement, feeling and circulation during the first couple of days after surgery and/or cast placement. Notify your child's doctor of any decrease in circulation, decrease in the ability to move the fingers, or numbness or tingling in the fingers.
Encourage your child to move their fingers.
Keep the cast dry and clean. Waterproof casts cannot be used for fractures with pins in place as it increases the risk of infection.
Your child's doctor will order pain medication for you to give your child at home. Follow the directions on the label carefully. If the pain medicine does not work, call the orthopaedic nurse or doctor.
Pin Tract Infection
About 3% of patients can develop a pin tract infection. This usually happens if the cast gets wet. Call your doctor if the cast gets wet.
Signs of infection include:
- Increasing elbow pain or fussiness after the first week
- Fever
- Drainage out of the cast
If your child develops any of these symptoms, call the orthopaedic nurse or doctor right away.
Baths Only; No Showers
You should place a plastic bag over the casted arm and tape it tight at the top (at the armpit). Never put the arm under water or allow water to run over it. Place the casted arm on the side of the tub and watch the child to make sure they keep the cast out of the water. If it should get wet, immediately dry the cast with a blow dryer using the cool setting only. If this does not dry the cast, call your doctor immediately for further instructions. A wet cast can cause infection if not taken care of right away.
Activities
Your child should avoid any activities that may increase the likelihood of tripping and falling. When your child feels well enough and no longer needs narcotic pain medicine, they may return to school wearing a sling. Place a safety pin between the two sling layers, just in front of the elbow, to help keep the sling from sliding off of the arm.
Cast Removal
After the elbow is healed, your child may have elbow stiffness that lasts for three to four weeks after the cast is removed. Children often hold their arm for the first few hours after their cast is removed due to elbow stiffness. The stiffness usually goes away on its own within a month after cast removal.
Pin Removal
Elbow pins are removed in the office. Although patients may be anxious or cry, the pain is minimal or not painful at all. Patients may begin working on range of motion activities as tolerated with normal activities at home.
Physical therapy is usually not necessary. Patients are allowed to swim once the skin pin holes have closed, which is usually within 36 hours. Water therapy is a great way to improve range of motion. Your child can play sports once they have near full motion (approximately one to four weeks after cast removal).
Follow-Up
Your child's provider will tell you when your child needs to return for follow-up care. X-rays will be taken to determine how the healing is progressing.
