Being a parent means catching our kids when they fall–both figuratively and literally. Nearly every parent has had to turn into a pseudo-superhero and practically fly across the room to catch their wobbly toddler before they smacking their face on a hard surface. But as kids get older and more active, it becomes impossible to protect them from every accident. And as terrible as that feels, there’s truly nothing we can do except be prepared for when the inevitable happens—especially if an injury leads to the need for orthopedic fracture surgery.
For half a decade now, The Everymom has strived to be a go-to resource for whatever kind of motherhood moment you’re in: the good, the bad, the scary. We’ve put together a comprehensive guide with the help of the medical experts at Ann & Robert H. Lurie Children’s Hospital of Chicago’s Division of Pediatric Orthopedics to answer all your questions regarding common surgical procedures. They’re sharing everything you need to know about surgery for one of the most common orthopedic fractures: supracondylar humerus fractures, or fractures of the elbow.
Orthopedic Fracture Surgery: A Guide for Parents
1. What is orthopedic surgery and why might my child need it?
Supracondylar humerus fractures are one of the most common injuries in children that require surgery by a pediatric orthopedic surgeon. This fracture occurs at the elbow (end of the humeral bone) when the child falls onto their outstretched hand. The force of the fall causes the fractured bones to move out of alignment (displacement) which can cause reduced elbow range of motion long-term unless the bones are set back into normal alignment.
Surgery for this fracture includes a general anesthetic to keep the child comfortable and safely asleep. The pediatric orthopedic surgeon then sets the bones back into place in order to facilitate appropriate healing of the fracture and reduce the risk of deformity or future loss of motion at the elbow. The bones are held in place with temporary metal pins that exit outside the skin but are covered with a fiberglass cast. The pins get removed in outpatient clinic 3-4 weeks after surgery.
2. Is this an inpatient or outpatient procedure?
This surgery is typically performed on an outpatient basis with discharge to home a few hours after surgery.
3. Do you have any tips for easing both mom and child’s anxiety leading up to the procedure?
Educating and empowering the child are critical ways to reduce the anxiety surrounding surgery. Lurie Children’s has online resources that can be used to educate and empower children. Additionally, we have a child life team to help address some of the social and emotional concerns around surgery and surgery preparation.
4. What is the best way to physically prepare a child for this surgery beforehand?
In general, the stomach must be completely empty for the day of the procedure. Depending on the time of the procedure, the child may have to stop eating the night before and drinking clear liquids an hour before. A nurse will give specific directions tailored to your child’s procedure before it’s scheduled.
5. What will be done to manage my child’s pain during the procedure?
Local numbing medication can be placed in and around the pin sites at the conclusion of the procedure as long as the child doesn’t have any allergies to medications. Over-the-counter acetaminophen and ibuprofen can be used post-procedure to help control pain as long as the child does not have any allergies to these medications or other contraindications.
6. What will the post-operative and recovery phase look like?
Initial recovery from the procedure requires monitoring in the recovery room for a few hours. Once the patient is able to tolerate drinking and eating and pain is appropriately controlled with a good exam, the patient may be discharged to home. Depending on the age and severity of injury, the child will be casted for three to four weeks. At that point, the child will return to the clinic with x-rays to determine if the cast and pins may be removed in clinic. Full return to activities is typically restricted for eight weeks after the day of injury.
7. Post-procedure, what symptoms should I be monitoring for that might suggest I should contact our doctor?
While very rare, compartment syndrome is a known risk with supracondylar humerus fractures. If your child experiences pain that can’t be controlled with the prescribed pain medications, you should immediately bring your child to the emergency department for emergent cast removal and evaluation for compartment syndrome.
8. Will this injury impact my child’s future growth or mobility in any way?
The goal of surgery is to reestablish the anatomic alignment of the elbow to prevent deformity or decreased range of motion. Initially, the child will have stiffness during recovery. But with appropriate healing will be cleared for full activities approximately eight weeks after surgery.
9. Will my child need to wear a cast during recovery? For how long?
A long-arm cast will be in place for three to four weeks. It will need to remain clean and completely dry. Casts can also be itchy secondary to sweating, skin irritation, and swelling. Absolutely nothing should be stuck into a cast to alleviate the itch. To address itching appropriately, you can use a hair dryer on a cool setting to cool the cast and dry out the skin. It can even be placed directly on the cast to facilitate a sense of vibration and ease the itching sensation. If the cast does get wet, call your provider immediately to discuss next steps.
10. Do you have any advice about how I can help my child go back to school with a cast?
Encourage good hand hygiene with the use of hand sanitizer instead of hand washing to prevent the cast from getting wet. A sling may be used in crowded environments to help shield the cast and prevent bumping, tripping, or falling. Extra time between classes can help facilitate ease of walking. A friend or aide to help carry a backpack or books may be provided to prevent any weight bearing through the fractured arm. The cast should allow for adequate typing and/or handwriting to continue school work. A modified sitting position or desk height may be required to help facilitate comfort and can be accommodated by the school.
Want to learn more? Check out what the specialists from Ann & Robert H. Lurie Children’s Hospital of Chicago are sharing here.
This post was in partnership with Ann & Robert H. Lurie Children’s Hospital of Chicago, but all of the opinions within are those of The Everymom editorial board. We only recommend brands we genuinely love.