Elbow Fracture: Olecranon Fracture

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KEY POINTS

• An olecranon fracture is a break in the bony tip that you feel directly under the skin of the elbow.
• Treatment may include surgery, a splint or cast, and special exercises to help your child’s arm get stronger and more flexible.
• Follow the full course of treatment your child’s healthcare provider prescribes.

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What is an olecranon fracture?

An olecranon fracture is a break in the bony tip that you feel directly under the skin of the elbow. The break may be just a bend or small crack in the bone, or the bone may break into pieces or shatter. Some fractures may stick out through the skin.

What is the cause?

The usual causes of a broken elbow are a fall or a direct hit to the elbow. A fracture may also be the result of a medical condition that causes weak or brittle bones.

What are the symptoms?

Symptoms may include:

• Pain, swelling, bruising, or tenderness that happens right after the injury
• Pain when the injured area is touched
• Pain or swelling that keeps your child from bending or using the arm
• An area of the elbow or forearm that is cold, pale, or numb
• A change in the shape of the elbow

How is it diagnosed?

Your child’s healthcare provider will ask about your child’s symptoms and how the injury happened. Your provider will examine your child. Tests may include:

• X-rays of the elbow
• CT scan, which uses X-rays and a computer to show detailed pictures of the bones
• MRI, which uses a strong magnetic field and radio waves to show detailed pictures of the bones

How is it treated?

The treatment depends on the injury.

• If your child has an open wound with the fracture, your child will need treatment to control bleeding or prevent infection.
• If just a small piece of bone is broken at the end of the bone, it may be treated with just a splint or cast. If a larger part of the bone is broken and out of place, or if the break goes into the joint, your child may need surgery to repair the bone. Your healthcare provider may use a pin or screw to keep the repaired bone in place.
• Sometimes the joint gets dislocated, which means the bone has moved out of place in the elbow joint. If the joint is dislocated, it will need to be put back into place. Your child will be given medicine first so putting the joint back into place is less painful.
• Your child’s arm may need to be in a sling as well as a splint or cast to keep it from moving while it heals. If your child has a cast, make sure the cast does not get wet. Cover the cast with plastic when your child bathes. Teach your child not to scratch the skin around the cast or poke things down between the cast and the skin. This could cause an infection.

With treatment, the fracture may take up to several months to heal. Your child may need to do special exercises to help the arm get stronger and more flexible. Ask your child’s healthcare provider about this.

How can I take care of my child?

Follow the full course of treatment your child’s healthcare provider prescribes. Also:

• To keep swelling down and help relieve pain, your child’s healthcare provider may tell you to:
  • Put an ice pack, gel pack, or package of frozen vegetables wrapped in a cloth on the injured area every 3 to 4 hours for up to 20 minutes at a time for the first day or two after the injury.
  • Keep the arm up on pillows so that it is above the level of the heart when your child is sitting or lying down.
  • Give your child pain medicine, such as ibuprofen, as directed by your child’s provider. Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, may cause stomach bleeding and other problems. Read the label and give as directed. Check with your healthcare provider before you give any medicine that contains aspirin or salicylates to a child or teen. This includes medicines like baby aspirin, some cold medicines, and Pepto-Bismol. Children and teens who take aspirin are at risk for a serious illness called Reye's syndrome.

Ask your child’s healthcare provider:

• How and when you will get your child’s test results
• How long it will take for your child to recover
• If there are activities your child should avoid and when your child can return to normal activities
• How to take care of your child at home
• What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent a broken elbow?

Most broken elbows are caused by accidents that are not easy to prevent. Teach your child to be careful when he or she plays or exercises. Knee pads, elbow pads, and a helmet can help prevent injuries during activities like biking, rollerblading, or skateboarding.