When a crash leaves a child with a swollen elbow
Advice from a pediatric orthopedic surgeon and an emergency physician
In a crash, a child may brace against the seat or bang an elbow. Pain and swelling around the elbow can be a sign of a break just above the joint. Doctors call this a supracondylar fracture. Whether the bone is broken is only part of the question. The nerves and blood vessels that serve the hand also need checking. [1]
Have a doctor look at the elbow
Get prompt medical care if your child can’t move the elbow normally or won’t use the arm. Tell the doctor how the arm got hit. They’ll check the skin and the hand’s color and warmth. They’ll also test finger movement, feeling and pulses. X rays usually show the injury. Until the elbow is checked, don’t force it straight or let your child lift things with that arm. [1]
Signs of a blood flow or nerve problem
A hand that is pale, cool, more and more numb or hard to move needs emergency care. Tell the team right away if these signs show up after a splint or cast goes on. Pain that keeps getting worse and won’t settle also needs an urgent second look. [1]
In a displaced fracture, the broken pieces have moved out of line. It may need prompt treatment to line the bone back up and protect the hand. [1]
Learn how the break will be treated
A break that hasn’t shifted may heal in a splint or cast. One that has shifted may need the bones moved back into place and held with temporary pins. Ask how the team will keep track of swelling. Find out when the hand should be checked again and when the next imaging test is due. Keep the follow up visit even if your child seems comfortable. [1]
Ask about the hand and fingers
- Is blood flow to the hand normal?
- Can my child move and feel every finger?
- What change means we should come back tonight?
Compare both hands
Check the hurt hand’s color, warmth and finger movement against the other hand. [1]
Sources and further reading
The information here is general, drawn from pediatric orthopedics and emergency medicine. A painful or swollen elbow needs an in person exam. A hand that is pale or cold needs emergency care.
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