Elbow (Radial Head) Fracture and Cast: How to Care for Your Child

A radial head fracture is a type of elbow fracture. It happens when there's a break in the radius bone, which connects the elbow to the wrist. The part of the radius that joins the elbow joint is called the "radial head."

Your child got a cast along with a sling to support it. You can help your child by going to all follow-up visits and taking good care of the cast.

• To reduce swelling in the first 24–48 hours:

  • Use pillows to raise the arm above heart level when your child is sitting down or sleeping.

  • When your child is awake, put cold packs wrapped in a towel on the cast for 20–30 minutes every 3–4 hours. Don't put ice directly on the cast. The cast must stay dry.

• For pain: 

  • Give your child acetaminophen (Tylenol^® or a store brand) OR ibuprofen (Advil^®, Motrin^®, or a store brand) as recommended by the care team. Follow the package directions for how much to give and how often. 

  • If your doctor prescribed a pain medicine but your child still has pain, ask the doctor or pharmacist if it is OK to also give your child acetaminophen or ibuprofen.

Daily cast care:

• Remind your child to wiggle the fingers to keep blood circulating normally.

• Check that the fingers have normal feeling, warmth, and color.

• Check the edges of the cast: Make sure your child isn't picking at or removing the padding from the edges. Make sure the skin near the cast isn't scratched.

• Don't put anything in the cast. Make sure your child doesn't put toys, food, or other objects into it.

• Keep dirt, sand, lotion, and powder away from the cast.

• Your child should use the sling when up and walking around. Don't let your child wear the sling while sleeping.

• Keep the cast dry:

  • No swimming.

  • Give sponge baths to kids younger than 5 years old.

  • Older kids should take baths instead of showers.

  • Put a plastic covering over the arm when your child bathes. Put the arm up on something to keep the cast completely out of the water.

  • If the cast is accidentally splashed, gently blow air into it from a hair dryer on the cool setting.

Problems to watch for:

• Sharp edges: Put tape or moleskin (available at drugstores) on any rough spots.

• Itching: Tap lightly on the cast or use a hair dryer on the cool setting to blow air in and around the edges. Don't let your child scratch under the cast or put anything into it.

• Swelling: If the fingers look puffy, raise the arm above the level of the heart for 1 hour. If the swelling doesn't get better, call your health care provider.

Be sure to:

• Schedule a follow-up visit with the orthopedic specialist as recommended.

• Have your child avoid gym class, sports, and playground equipment and activities until the orthopedic specialist says it's OK.

• The pain continues while your child is taking pain medicine.

• The pain gets worse, especially when your child stretches out the fingers.

• Your child's fingers stay swollen even after propping up the arm for 1 hour.

• Your child has a fever.

• The skin around the cast looks red or raw.

• The cast:

  • gets wet

  • feels too tight or too loose

  • is damaged or smelly

  • has something stuck inside it

Your child's fingers tingle or become numb, blue, or pale.

How do elbow fractures happen? This type of fracture can happen when kids hold out their arm to try to stop a fall.

How long will my child have a cast? Healing time varies, but a cast usually is worn for 2–4 weeks.