Elbow injury: Supracondylar humerus fracture

Your child has broken their arm just above the elbow. The medical name for this is a supracondylar humerus fracture.

Elbow fracture (supracondylar humerus fracture)

Will my child need a sling?

Yes, your child will need to wear a backslab (a cast that goes halfway around the arm) and a sling to allow their bones to heal properly. The backslab supports the bone as it heals. The sling helps your child keep their arm in a comfortable position until they can move it again.

Your child will be fitted with the backslab and sling before they leave hospital. Your child’s health-care team will show you how to make a basic forearm sling when you are at home. It is often easiest to have your child wear the backslab and sling under loose clothing instead of through a shirt or sleeve.

What to expect in the first 24 to 48 hours after injury

Pain

You child will have pain in their elbow at first. To reduce pain, give your child ibuprofen as needed, following the directions on the bottle.

Swelling

Your child’s arm, hand and fingers may swell in the first 24 to 48 hours after injury. To decrease this swelling, have your child rest their arm on a pillow when sitting or lying down.

Possible changes in temperature, colour and movement

If the backslab is too tight, it can limit blood flow to and from your child’s hand and fingers. Encourage your child to bend and straighten their fingers every hour while they are awake. Check the temperature, colour and movement of your child’s fingers about every four hours while they are awake.

In particular, check if:

• your child has severe pain when moving their fingers
• your child’s fingers are blue or white
• your child’s fingers are cold (compare them to the fingers on their other hand)
• your child’s fingers cannot curl up or straighten out
• your child has numbness or pins and needles in their fingers.

When to return for a follow-up appointment

If there are no serious problems with your child’s recovery, your child will have their first follow-up appointment in the fracture clinic about seven to 10 days after injury. The doctor will check that the injury is healing as expected and teach you how to remove your child’s cast at home. Your child will not usually need any further follow-up.

How to remove your child’s cast

Your child’s doctor will instruct you to remove the backslab three weeks from the date of your child’s fracture. Removing the backslab is not difficult. Simply cut up the front soft part of the half cast carefully with scissors and gently remove it from the arm.

After removing the backslab, your child's arm may look dirty and be dry and itchy. Use warm water and soap to gently wash the arm and moisturize the skin with cream.

How soon after removing the cast can my child move their arm?

When the backslab is off, your child can begin moving their elbow. At first, the elbow and wrist may be stiff. The movement will get better with time, but this may take up to one year. Your child will not need physiotherapy.

How can I reduce the risk of further elbow fractures?

To reduce the risk of a repeat fracture, your child should avoid high-risk activities for 12 weeks after their injury. High-risk activities include playing on monkey bars, ice-skating, skateboarding, contact sports and other activities where falls are likely.

What to do if you notice a problem

If you child has any signs of severe pain, numbness or changes in colour or temperature, have them rest their arm on a pillow for 30 minutes while lying down. If the problem does not get better, call your doctor or go to your nearest hospital.