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Paediatric Elbow Injuries
Paediatric Elbow Injuries
Elbow injuries are common in children, especially those active in sports or play. The elbow is a complex joint that allows for a wide range of motion and is susceptible to various injuries, including fractures, dislocations, and ligament strains. The most common fracture is a supracondylar fracture of the humerus, which affects the elbow.
Children are particularly vulnerable to elbow injuries because their bones are still developing. Early diagnosis and treatment ensure proper healing and prevent long-term complications.
Symptoms
Pain
Sudden, sharp pain in the elbow, particularly after a fall or direct impact. A pulled elbow occurs when a child’s upper limb is pulled suddenly or when the child has a minor fall. The radial head is subluxated in this event, resulting in severe pain for the child.
Swelling
Swelling around the elbow joint may occur shortly after the injury.
Bruising
Bruising around the elbow may develop, indicating trauma.
Limited Movement
Difficulty moving the elbow, especially when bending or straightening the arm.
Deformity
The elbow may appear visibly deformed in dislocation or severe fractures.
Numbness or Tingling
Damage to nerves in the elbow can cause numbness, tingling, or weakness in the hand or forearm.
Causes
- Falls: Falling onto an outstretched hand or directly onto the elbow is one of the most common causes of injury.
- Sports Injuries: High-impact or repetitive activities such as throwing in baseball or gymnastics can place stress on the elbow joint.
- Direct Impact: A blow to the elbow during contact sports or accidents can lead to fractures or other injuries.
- Overuse: Repetitive motions, such as throwing or lifting, can lead to overuse injuries, particularly in young athletes.
Risk Factors
- Participation in Sports: Children involved in sports like baseball, gymnastics, and football are at higher risk for elbow injuries.
- Falls: Younger children who are still developing coordination and balance are more likely to fall and injure their elbows.
- Overuse: Repetitive motions, such as throwing in baseball or serving in tennis, can lead to overuse injuries in the elbow.
- Growth Spurts: During rapid growth, the muscles and tendons may not keep pace with bone growth, increasing the risk of injury.
Diagnosis
- Physical Examination: The doctor will assess the child’s range of motion, look for signs of deformity, and check for tenderness or swelling around the joint.
- X-rays: X-rays are commonly used to determine the severity of the injury and identify fractures or dislocations.
It is essential to have an x-ray as other fractures can occur with this fracture, whereby surgery is important to prevent long-term problems like malunion or non-union in lateral condylar fractures, displaced radial neck fractures or medial epicondylar fractures.
Forearm fractures near the elbow may also result in dislocation of the radial head, which requires accurate reduction to prevent long term issues.
- MRI or CT scan: In more complex cases or when soft tissue damage is suspected, MRI or CT scans may be used to obtain a more detailed view of the injury.
Rehabilitation
- Physical Therapy: After the initial healing phase, physical therapy helps restore strength, range of motion, and function to the elbow.
- Activity Modification: Children may need to modify activities that place stress on the elbow during recovery, particularly for overuse injuries.
Complications
Although most paediatric elbow injuries heal well with appropriate treatment, complications can occur:
- Growth Plate Injuries: Fractures involving the growth plate (the area of developing tissue near the ends of long bones) can affect future bone growth and lead to deformity.
- Stiffness: If the elbow is immobilised for a prolonged period, the joint may become stiff, limiting range of motion.
- Nerve Damage: Injuries that cause significant trauma to the elbow can damage nearby nerves, resulting in numbness, weakness, or tingling in the hand and forearm.
- Nonunion or Malunion: In rare cases, fractures may not heal properly (nonunion) or may heal in an incorrect position (malunion), requiring further treatment.
- Chronic Instability: Ligament injuries that are not properly treated can lead to long-term instability of the elbow joint, increasing the risk of re-injury.
When To See A Doctor
If your child experiences severe pain, swelling, or difficulty moving the elbow after a fall or injury, seek medical attention promptly. Early treatment is key to preventing long-term complications and ensuring proper healing. With timely treatment and rehabilitation, most paediatric elbow injuries heal completely, allowing children to return to their normal activities. However, close monitoring and adherence to rehabilitation protocols are essential to avoid complications, especially in cases involving fractures near the growth plate.
Doctors In-Charge
Specialist Orthopaedic Surgeon
Specialist Orthopaedic Surgeon