If an elbow fracture heals in the wrong position, the elbow may remain permanently crooked and have limited range of motion. For this reason, it is important that the fracture be treated correctly at the time of the initial injury.
Treatment for elbow fractures depends on the type of fracture and the degree of displacement
How is a child’s elbow fracture treated without surgery?
Many stable fractures in children can be treated by keeping them from moving with cast or splint. If the fracture is stable with no displacement, your doctor may directly apply a splint or cast to keep the bones in proper position while they heal.
Splints provide less support than casts, but they can be easily adjusted to accommodate swelling from injuries. In many cases, a splint is applied to a fresh injury first. As swelling goes down, your doctor may replace the splint full cast.
In some stable elbow fractures, the bones may need to be repositioned before applying a splint or cast. In this procedure—called a closed reduction—your doctor gently moves the arm to manipulate the bones back into place. Your child will be given some form of sedation or anesthesia for this procedure.
As the fracture heals, your doctor may schedule additional x-rays to make sure the bones stay in place.
How is a child’s elbow fracture treated with surgery?
If the bone fragments are displaced, surgery may be needed to make sure that the fracture heals fully. Two common types of surgery are:
- Closed reduction and percutaneous pinning. In this procedure, the bone fragments that have moved out of place are repositioned during closed reduction and held in place with metal pins. The pins are inserted through the skin, into the bone and across the fracture. A splint is applied to protect the area for the first week, then is typically replaced with a cast. The pins and cast are removed after healing has begun, a few weeks after surgery.
- Open reduction and internal fixation. Open fractures, fractures that cannot be repositioned during a closed reduction, and fractures that are accompanied by nerve or vascular injuries require open surgery or open reduction and internal fixation.
How long will it take a child to recover from a fractured elbow?
Whether the fracture is treated by simple immobilization or with surgery, the arm will be placed in a cast or splint for 3 to 6 weeks, depending upon the fracture.
When the fracture is well enough healed, the doctor may recommend specific exercises to improve the range of motion in the joint.
In most cases, the elbow's range of motion returns to normal, or has just a mild limitation.