Fracture of the arm of a child

The arm is generally divided into upper arm, forearm and hand. These are connected by the elbow joint and wrist. The bone of the upper arm is called humerus (large tubular bone), the forearm is made up of ulna and radius.

The hand is formed by the eight carpal bones and the adjacent metacarpals and phalanges. First of all, it should be noted that broken arms behave very differently in children than in adults. Firstly, the type of fracture is different due to the much more flexible bone that is being built up.

Secondly, children have a faster and better self-healing tendency. If growth joints are affected, special care must be taken. This is because there is a risk that growth will be permanently impaired and malpositions can follow if the treatment is not appropriate.

Cause

There are different types of fractures of the upper arm. In a fracture of the humerus shaft, the middle part of the tubular bone is damaged. This generally happens rarely, but if it does, it is often caused by a fall or in traffic accidents.

A fracture of the lower end of the upper arm is also called distal humerus fracture, supra – or epicondylar humerus fracture (the lower end of the humerus is called condyle) and is usually caused by a fall on the stretched arm. This often affects the elbow joint. In the case of a broken forearm, the spoke fracture in particular is one of the most common fractures in childhood and is usually caused by falls during sports such as handball, skating or snowboarding, which involve a relatively high risk of falling.

Symptoms

In every tenth child the fracture is not obviously recognizable by the parents. Typical signs of swelling may be absent and existing mobility should not automatically lead to the exclusion of a fracture. If a child has severe pain in the arm after a fall or collision, a doctor should always be consulted.

In most cases, however, typical signs such as numbness or a feeling of cold, swelling, restricted mobility or malpositioning should be listed alongside pain. The pain of a fracture is often very strong. They are caused by the irritation of the periosteum.

Ibuprofen and paracetamol are painkillers for children. Here, attention must be paid to the respective dosage, which is based on the child’s body weight. Distraction of the children often also helps well against pain.

Diagnosis

It is important to describe the injury mechanism to the doctor as precisely as possible. This alone can often provide information about the location or type of fracture. In addition, the doctor will carry out a detailed physical examination to check for movement restrictions, incorrect or relieving postures, blood circulation and sensitivity. The diagnosis is confirmed by an X-ray. In exceptional cases, for example if the injury was caused by an apparently too minor trauma (a so-called minor trauma) and the bone and tissue structure should be examined more closely, a magnetic resonance tomography (MRI) or computer tomography (CT) is indicated for a broken arm.