Shoulder Fracture (Child) 

Your child has a break (fracture) in one or more bones of the shoulder. The shoulder is made up of the collarbone (clavicle), shoulder blade (scapula), and the top of the upper arm bone (humerus). When a bone is fractured, it causes pain, swelling, and bruising.

X-rays or other imaging tests help confirm the fracture. A sling may be put on your child to hold the shoulder bones in place. In some cases, a cast or splint may be used instead. In severe cases, the bone must be realigned so it heals properly. This may require surgery.

Until the end of adolescence, bones contain growth plates. A growth plate allows the bone to grow as the child grows. If a growth plate is fractured, there is a small chance that it will affect the future growth of the bone. You will be told whether a growth plate is involved in your child’s fracture. A growth plate fracture will be watched closely as it heals.

Fractures are uncommon in babies younger than 1 year old. This is because their bones are very soft and flexible. If your child has not had a major injury like a car accident, the fracture may mean your child has a problem with bone growth. Tests may be done. Or you may be referred to a specialist to find out if your child has another health condition. 

Home care

Your child’s healthcare provider may prescribe medicines for pain. Follow the provider’s instructions for giving these medicines to your child. Don’t give your child aspirin unless the provider tells you to.

General care

  • Follow the provider’s instructions about how much your child should use the affected shoulder and arm.

  • Make sure your child wears the sling until you are told otherwise. If it becomes loose, adjust it so that your child’s forearm is level with the ground (horizontal). Your child’s hand should be level with his or her elbow.

  • Apply a cold pack to the injury to help ease or control the swelling. You can make a cold pack by wrapping a plastic bag of ice cubes in a thin towel. A frozen bag of peas works well, too. As the ice melts, be careful that the cast or sling doesn’t get wet. Don't put the ice directly on the skin, because this can cause damage. It may be hard to use the cold pack because most children don't like the feel of cold. Don't force your child to use the ice. This can make both of you miserable. Sometimes it helps to make a game of it. 

  • Hold the pack on the injured area for up to 20 minutes every 1 to 2 hours the first day. Continue this 3 to 4 times a day for the next 2 to 3 days. Then use as needed. The cold pack can be put directly on the splint or cast. 

  • Care for the sling, splint, or cast as you have been told to. Don’t put any powders or lotions inside the sling, splint, or cast. Keep your child from sticking objects into the sling, splint, or cast.

  • Keep the sling, splint, or cast completely dry at all times. You can take off a sling when your child takes a bath. Cover a splint or cast with a plastic bag and keep it out of the water when your child takes a bath. Close the top end of the bag with adhesive tape.

  • Encourage your child to wiggle or exercise his or her fingers on the hand of the injured arm often.

Follow-up care

Follow up with your child’s healthcare provider, or as advised. Your child may need follow-up X-rays to see how the bone is healing. If you were referred to a specialist, make that appointment right away.

Special note to parents

Healthcare providers are trained to recognize injuries like this one in young children as a sign of possible abuse. Several healthcare providers may ask questions about how your child was injured. Healthcare providers are required by law to ask you these questions. This is done to help protect the child. Please try to be patient and not take offense.

Call 911

Call 911 if any of these occur:

  • Trouble breathing

  • Confusion

  • Very drowsy or trouble awakening

  • Fainting or loss of consciousness

  • Rapid heart rate

  • Seizure

  • Stiff neck

When to seek medical advice

Call your child's healthcare provider right away if any of these occur:

  • Fever (see Fever and children, below)

  • Pain or swelling gets worse. Babies too young to talk may show pain with crying that can't be soothed. If the splint is on, loosen it before going for help. 

  • Swollen, cold, blue, numb, burning, or tingly fingers on the hand of the injured arm

  • Your child can’t move his or her fingers on the injured arm

  • Cast or splint becomes soaking wet or soft and doesn’t dry after using a hair dryer

  • Areas under the cast become sore or have a foul odor

  • Tingling in the fingers or hand that is new or getting worse

  • Fussiness or crying in babies that can't be soothed

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds of digital thermometers. They include ones for the mouth, ear, forehead (temporal), rectum, or armpit. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Use a rectal thermometer with care. It may accidentally poke a hole in the rectum. It may pass on germs from the stool. Follow the product maker’s directions for correct use. If you don’t feel OK using a rectal thermometer, use another type. When you talk to your child’s healthcare provider, tell him or her which type you used.

Below are guidelines to know if your child has a fever. Your child’s healthcare provider may give you different numbers for your child.

A baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

A child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older


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