Broken Arm Basics

Whether you or someone you love has a child with a broken arm or you just suspect your child has a broken arm – start here to get an overview of what to do next.

broken-arm-xrayEmergency situations

If you even think for a half-second that your child has any of the following symptoms, call 911 and get medical help quickly:

  • trouble breathing or loss of consciousness
  • bone sticking through the skin
  • non-stop bleeding from a cut where the worst pain is on the arm
  • extreme swelling or bruising with tingling and numbness
  • extreme deformity of the arm

Ways to tell a fracture from a bad sprain or bruise

You can get more details about elbow fractures and broken wrists on my website, but here are some general signs that are very suspicious for fracture:

  • swelling and bruising
  • abnormal shape or deformity of the arm or wrist
  • pain when moving the joints around the injury
  • lots of pain at night
  • pain that won’t get better with Tylenol or ibuprofen
  • refusal to use the arm or to put weight on it
  • stiffness or tightness in the joints around the injury

What is a fracture?

A fracture is the same thing as a break. Many patients and parents think one is better or worse than the other. Medically and technically there’s no difference.

When a bone breaks, it starts bleeding. This begins the healing process.

The body’s immune system goes into overdrive when this happens, sending blood and white cells to the injured area right away. This creates pain, swelling, bruising, and stiffness.

To heal right, the broken pieces of bone must be lined up the right way for about 6 weeks. This may be a complex or a simple process, depending on how displaced (far apart) the pieces are.

Arm fractures become more difficult to treat when

  • the bone comes through the skin
  • nerves or blood vessels are damaged (very rare)
  • the fracture goes into or around a joint
  • fractures happen in older children (surgery necessary more frequently)

Why children’s fractures are different than adult fractures

Children’s bones are softer

Bones in kids are softer, so they tend to bend rather than just snap. This is like breaking a freshly picked green stick versus breaking a dried old twig that’s been in a sunny field for a year.

Straightening power

Bones straighten out better in kids than in adults. Because adults are finished growing, we have less “straightening-out”, or remodeling potential when we break our bones. The younger they are, the more potential a child has to straighten a crooked bone while it heals.

Faster healing in children

Because kids are not done growing, their bones are constantly getting longer. This pace of growth slows down with age, but helps children heal much faster than adults when they break a bone.

For example, in an adult fracture, you won’t usually see any new bone forming on an x-ray until 5 weeks after a break. In a young child, bone is formed and visible on x-rays in a couple of weeks!

Potential growth problems

The same part of a bone that makes it grow in children can also be injured in a fall or other trauma. This makes kids’ bones more fragile than adult bones.

If the growth plate is injured badly, the normal growth process of the bone can stop, creating pain, stiffness, deformity, or difficulty using the arm.

Fewer problems with stiffness

Fortunately, children have less stiffness after healing than adults. One of the complications of being in a cast is stiffness of the joints; this is rarely a problem in kids after the healing process takes place.

What to do if you suspect your child has a fracture

It’s better to be safe than sorry when deciding to go to the doctor or the emergency room. If you have any doubt, take your child to a doctor as quick as possible.

A well-padded ice pack can help with swelling, applied directly to the painful spot.

Don’t hold the ice directly on the skin, though.

Apply the ice for no more than 5-10 minutes, but repeat this every few hours.

Possibly more important than ice is keeping the arm propped up on pillows above the heart, so swelling can go down. This will often eliminate the majority of your child’s pain.

Fortunately, most children protect themselves when they have a fracture; you don’t have to do anything special to keep them from using the arm. Make sure to avoid lifting or gripping if you suspect a fractured arm.

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