Upper Extremity Fracture (Child)  

Your child has a broken bone or fracture in the upper extremity. The upper extremity includes the shoulder, arm, wrist, or hand. A broken bone often causes pain, swelling, and bruising.

To check for a broken bone, X-rays or other imaging tests are done. The arm is then put into a splint or a cast to hold the bone in place while it heals. A sling may also be used. Most broken arm bones heal well without surgery. But if the bones are far out of place or if the break is near the elbow, surgery may be needed.

Home care

  • If your child was given a sling, leave it in place. It will support the hurt arm. This is the best position for bone healing. The sling may be adjustable. If it becomes loose, adjust it so that the forearm is level with the ground. The hand should be level with the elbow.

  • Apply an ice pack to the injury to control swelling. Hold the pack on the injured area for 15 to 20 minutes every 1 to 2 hours the first day. Do this 3 to 4 times a day for the next 2 days, then as needed. To make an ice pack, put ice cubes in a plastic bag that seals at the top. Wrap the bag in a clean, thin towel or cloth. Never put ice or an ice pack directly on the skin.The cold pack can be put directly on the splint or cast. As the ice melts, be careful that the cast or splint doesn’t get wet.

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

  • Keep the splint or cast and sling dry. For bathing, the sling can be removed. The splint or cast should be covered with a large plastic bag closed at the top with tape or rubber bands  and kept out of the water.

  • If X-rays were taken, you will be told of any new findings that may affect your care.

General care

Your child may be prescribed medicines for pain. Follow the healthcare provider’s instructions for giving these medicines to your child.  If prescription pain medicines are not used, then you may use over-the-counter medicine as directed based on age and weight.

If your child has chronic liver or kidney disease or ever had a stomach ulcer or GI bleeding, talk with your healthcare provider before using these medicines. Don't give your child aspirin unless instructed by the child’s healthcare provider. Taking aspirin can put your child at risk for Reye syndrome. This is a rare but very serious disorder. It most often affects the brain and the liver.

Follow-up care

Follow up as advised by your healthcare provider. Follow-up X-rays may be needed to see how the bone is healing. If your child was given a splint, it may be changed to a cast at the follow-up visit. 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 for protection of the child. Please try to be patient and not get upset with them.

When to seek medical advice

Call your child’s healthcare provider right away if any of the following happens:

  • Wet or soft splint or cast

  • A bad smell comes from the cast

  • The cast or splint becomes loose

  • Splint or cast is too tight

  • Increased swelling or pain

  • Fingers of the hand on the injured arm are cold, blue, numb, or tingly

  • Child can’t move the fingers of the hand on the injured arm

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