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FRACTURED ELBOW in XRAY after fall. What to do?

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Hello Doctor(Orthopedics):

My 10 year old daughter fell in the park(while swinging in the monkey bar) and fractured her right hand Elbow on Aug/14th (Thu 8pm). On Aug 15th we visited one Urgent care center and they referred for X-Ray service which detected Fracture in Elbow.

They referred to Emergency service of nearby Hospital and ES team put Splint on her hand for support and advised us to see Orthopedics expert in next two days as Hospital does not have resident Ortho expert (ES team saw only X-ray report but not the X-ray picture which was in CD).

I am in USA and given that it's weekend so I do not have access for any Ortho expert advice on her fracture. Also, I am not sure how soon I will get appointment with Orthopedic expert.

I am a sharing with you all the documents (Hospital Emergency service report and X-Ray pictures) and requesting following advise –

1. Based on fracture in X-ray picture - should we wait for Ortho Doctor appointment on Monday/Tuesday OR

2. Rush to another Emergency service from big hospital who may have better facility for the treatment, just in case she needs any operation/reduction/or plaster cast for fracture.

1. No external injury/no bleeding
2. Unable to stretch her hand/unable to straighten her hand
3. First day pain was heavy, today it’s mild pain
4. Finger movement is proper

Your advise will help us make proper decision – i.e. wait for Ortho expert for Weekday consultation or rush to Emergency service for any quick treatment if that will help in faster healing of the fracture. Since it’s her right hand, so we are worried if this initial delay will prolong the fracture healing further. Also, it would be great if you can explain the problem(in common language) and how eventually Orthopedic expert will fix it.


Category: Orthopedic Surgeon

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Category: Spine Surgeon
 26 Doctors Online

Thank you for your query at

I have gone through all documents which you have sent me.
In the X-Ray there is positive fat pad sign. This indicates that it is an undisplaced fracture of lateral condyle and there is a minimally displaced fracture of supracondylar region on the medial side.
To put it in simple terms, the fractured bones are in line. There is no displacement, that is the bones have not moved out of place and there seem to be no complications.
You should not worry a lot but should take care of basic precautions which are written in the documents such as elevating the limb, doing active finger movements etc.
There is no need for urgent orthopedic consultation at present. You can consult him/her on a weekday. If there is a slab in place, then it will help in healing.

An orthopedic doctor will probably just review this as all the required measures have been taken. Continue analgesics & keep the splint/slab on.
Please do not worry as with all the precautions being followed well, the fracture will heal without any complications or abnormalities.

Hope this was helpful to you. Feel free to ask queries.


Patient replied :

Thank your very much Doctor for your reply. It’s helpful. I have follow-up questions here :

  1. X-ray#5 shows a broken bone piece, separated from main bone. Will it need any surgery or reduction to put it back to proper place ?
  2. Currently she is wearing a temporary splint, Emergency service suggested that when I visit Orthopedics, they will remove this temp Splint and put a cast later. Is there a recommended timeline which needs to be followed for permanent Cast ?
  3. Does she needs some exercises at this stage (finger movement etc) or stay in a state which prevents movement as much as possible.

Thanks and Regards.

Here are your answers-
1.It looks that you are asking about epiphysis.This is normal part of bone & contributes to growth of bone in child.The fractured part is miniimally displaced.It will leave no impact on growth of bone of child.
2.The use of temporary splint is for support & give space for normal post trauma swelling.Generally plaster cast is applied after 3-5 days when swelling after trauma subsides.
3.She can do finger movement.This will help in reduction of swelling as well as keep her muscles supple.
Hope this will help you.
Feel free to discuss further,
With best wishes.

Patient replied :

Thank you doctor for your prompt input, really appreciate it.
I will get back to you later if I need any further advise.
Thanks again to you and DoctorSpring for facilitation such a nice platform for patient and doctor interaction.
Happy Janmashtami !!
Regards, Prabhat

Thanks a lot for your appreciation!
I am extremely pleased to be able to help you.
Happy Janmasthtami to you too!
Take care,

Dr. Mukesh Tiwari
Category: Spine Surgeon
Fellowship - Khandaka Hospital, Jaipur
Residency - MS, Rabindranath Tagore Medical College, Udaipur, 2000
Medical School, Internship - MBBS, SMS Medical College, Jaipur, 1995
Dr. Mukesh Tiwari and 4 other Medical Specialists are ready to help you

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