Bones can break in many ways. Common types of fractures in children are:

• Greenstick. This is when the bone bends, but doesn’t break all the way through.

• Nondisplaced. This is when the bone breaks completely, but the ends stay lined up.

• Displaced. This is when pieces of broken bone don't line up.

• Growth plate. This is a break near or through the growth plate. This is the soft part of a bone where the bone grows as the child grows. A growth plate injury can slow growth in that bone. Growth plate injuries may be difficult to treat.

Fractures can be open (the broken bone comes through the skin). These used to be called “compound” fractures. Fractures can also be closed (the broken bone does not come through the skin).

Elbow fractures often result from

• Falling on an outstretched hand

• Falling on the elbow

• Forcing the elbow joint to move in an unnatural way

• Receiving a hard blow to the elbow

• Elbow swelling

• Pain

• Skin bruising or color change around the elbow

• Elbow deformity

• Stiffness, making the elbow hard to move

You may have brought your child to the emergency room for the initial treatment of the elbow fracture. A treatment plan must now be made to make sure the elbow heals properly. The healthcare provider will ask about your child’s health history and examine your child. An imaging test, such as an X-ray, will be done. Imaging tests show areas inside the body such as the bones. They give the provider more information about your child’s injury.

Your child’s treatment plan is determined by the type, location, and severity of the fracture. As instructed, your child should:

• Ice the elbow  3 to 4 times a day for  15 to 20 minutes at a time. This can help relieve pain and swelling. To make a cold pack, put ice cubes in a plastic bag that seals at the top. Wrap the bag in a clean, thin towel or cloth. Never put ice or an ice pack directly on the skin. The cold pack can be put right on a cast or splint.

• Wear a splint as instructed.

• Wear a cast for  3 to 6 weeks.

• Raise the arm to reduce swelling. Keep the elbow above heart level as often as possible.

• Do physical therapy to restore range of motion once the cast or splint is removed.

Some fractures may require closed reduction (moving broken pieces of bone back into alignment). Closed reduction is done from outside of the body and requires no incisions. For fractures of the joint, of the growth plate, or severe fractures, surgery may be needed. During surgery, fixation devices (pins that go through the skin into the bone) may be put into a broken bone to hold it in place while it heals. These devices may need to be taken out by the healthcare provider about  3 to 6 weeks after surgery.

• Fever (see “Fever and children” below)

• Chills

• Increasing pain

• Tingling, numbness, or pain around his or her cast or splint

• Increasing swelling around the injured area

• Fingers that change color or feel cold

• Severe itching under a cast (mild itching is normal)

• A cast that feels too tight or too loose

• Any drainage comes through or out of the end of the cast

• Blisters

• Decreased ability to move fingers

• A bad odor comes from underneath the cast

Take your child to the emergency department if your child has trouble moving his or her fingers or thumb.

Once your child’s cast is removed, his or her elbow may have:

• Short-term (temporary) stiffness and some loss of motion. This is normal. The elbow should still work well.

• Pain for  2 to 3 weeks, while the elbow continues to heal.

• A different look than before the injury.

In severe cases, the nerves and arteries of the elbow can be injured. This can cause complications and make healing more difficult. Your child’s healthcare provider will give you more information.

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

• Ask your child’s healthcare provider how you should take the temperature.

• Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

• Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

• Rectal, forehead, or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

• Armpit (axillary) temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

• Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

• Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.