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April 2017

Question:

My 8 year old son suffered a distal humerus fracture and dislocation and was operated on with K-wire inserted inside the bone. Now it's been almost 4 months. I want to know how many days total are required for healing and when the patient can be treated and play as normal without expecting injury if the elbow is hit.

- Steven - India (Parent)

 

Answer:

Great question! There are several common fractures that happen to the distal humerus in kids. The most common is a supracondylar fracture. That fracture is commonly treated with pin insertion for 3 to 4 weeks. It typically takes an additional 4 weeks for that fracture healing to mature so the elbow is back to baseline in terms of re-injury. Typically- kids need to work on slower play, range of motion and strengthening during that time. That fracture is almost never coincident with an elbow dislocation. The most common humerus fracture to be associated with an elbow dislocation is a medial epicondyle fracture. The greatest challenge for kids recovering from this injury is regaining their range of motion - because dislocating the elbow implies significant energy and soft tissue damage which tends to heal with stiff scar. The final fracture of the humerus at the elbow is a lateral condyle fracture. This fracture goes into the elbow joint and therefore can take a bit longer to heal. Most surgeons will not return a child to sport until that fracture is healed on x-ray (can take 8 weeks) and the range of motion at the elbow has returned. If your child is still painful at 4 months - I recommend returning to your pediatric orthopedic surgeon for x-rays. It is rare, but some kids develop a non-union which means the bone didn't heal properly and may need an additional procedure. I hope this helps.

- Elizabeth Weber, MD



 

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