Information for parents and carers
Supracondylar/elbow fracture
If your child has suffered a break in the bone (fracture) just above their elbow this is called a supracondylar elbow fracture.
If the fracture is undisplaced, this means the bones are still aligned. These fractures can be managed in a collar and cuff or a cast and a sling.
If the bones are out of alignment they are displaced. They may need surgery to have pins inserted which will hold the bones in place while the fracture heals.
They will then be placed in a full cast and a sling will be provided.
The cast and sling should be place under clothing and not passed through a sleeve.
Once you go home
Pain relief
Fractures are painful. The cast and sling will help to reduce the pain and additional pain relief should also be used (e.g. Paracetamol and Ibuprofen). Give the pain medication regularly for the first few days.
Elevation
During the first few days, it is important to rest and elevate the arm on pillows. The hand should be higher than the elbow and the elbow higher than the level of the heart/chest. This will help to reduce swelling.
Encourage your child to bend and straighten their fingers regularly and check their fingers for movement, feeling and colour. For more information see our Elevation leaflet.
Cast care
Avoid scratching inside the cast as this can damage the skin. Do not push objects inside the cast. Don’t attempt to cut or modify the cast.
It is important to keep the cast clean and dry. For showering and bathing, seal the cast in a waterproof bag. For more information see our leaflet – Plaster Cast Care.
When to get help
Concerns with the fingers that might mean the cast is too tight:
- Severe pain and swelling
- Change in colour (white or blue).
- Numbness or pins and needles.
- Inability to move the fingers.
If you see any of these signs, elevate the arm for 30 minutes. If the signs do not improve take your child immediately to the Emergency Department.
Concerns with the cast – bring your child to the Emergency Department:
- Cracked, soft, too loose or too tight.
- Concern an object has been pushed inside.
- Bad smell or oozing from the cast.
- Increasing pain.
Physiotherapy video
Follow-up
Undisplaced fractures – you can remove the collar and cuff or cast at home after 2 weeks.
Start to gently mobilise – see the physio guide for elbow exercises.
The elbow can get very stiff after these injuries, so it is very important to start mobilising.
If you have any ongoing concerns about reduced range of movement or ongoing pain, please make an ad hoc clinic appointment by calling 0131 312 0007 / 0131 312 0008.
Displaced fractures
Your child should have a follow up plan arranged before you leave the hospital. This usually involves attending the fracture clinic 7-10 days after the injury where a check x-ray will be done. Further instructions about cast removal and follow up will be given at clinic.
After cast removal
Your child should avoid sports and heavy arm use (such as climbing) for 1 month after removal of the sling or cast.
If you need any help or assistance, please call the Paediatric Emergency Department Reception: 0131 312 0017 or 0131 312 0018.
This leaflet was republished, with permission, from resources at The Royal Children’s Hospital, Melbourne, Australia. Images are subject to copyright.
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