The most common elbow fractures are supracondylar, lateral condyle, and medial epicondyle fractures of the humerus. These often occur during a fall, such as from the monkey bars. Many of these fractures can be treated with a cast, but they are more likely to require surgery.
If the fracture is “just a crack”, it can often be treated in a cast. The length of casting can vary, but it is usually 3-4 weeks. Sometimes, a child can fall and hurt the elbow, but no fracture can be seen on the X-ray. These fractures may be treated for a shorter period of time. Some fractures that are slower to heal may take longer.
Surgery for elbow injuries is the most common fracture surgery done in children! The fracture is manipulated into correct alignment and held in place with pins. For elbow fractures, the cast is not enough to hold the alignment and pins are needed. This is a very safe procedure to ensure good motion of the elbow.
You will follow-up 7-10 days after the surgery to get an X-ray and make sure everything is healing in the right position. Sometimes, a new cast will need to be placed, especially if swelling has gone down and it is not fitting well.
The cast and the pins will be removed in the office around 4 weeks. I recommend 2 weeks of limited activity after the cast and pins are removed.
I like to see patients back 4 weeks after the cast and pins are removed to check X-rays and the range of motion. Most kids will regain their motion without physical therapy, but this helps me identify the ones that may need some sessions to help them achieve their best results.