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Forearm injury, swollen. On immobilizer. Indicated slight pain on the opening. What is it?

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Orthopaedic Surgeon
Practicing since : 2000
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Hi. My question is ,my 8 year old son complained of a forearm injury from wrestling match. Later that night his elbow swelled mildly. No black and ice was applied,he had an xray done at his mothers request. No fracture seen,was told that elbow swelling is usually a crack or hair line crack. He was put in an immobilizer from bicep to wrist for 3 weeks. Do you need to isolate an elbow for 3 weeks every time you see swelling . Is this excessive,he was jumping around the following day and indicated slight pain on complete opening and complete closing of the arm . Note his mother hates the sport. How do I know the extent of the injury. Also my x wife went to this same hospital perfectly fine for a note to her boss and they put her on an I.v . And said she was extremely dehydrated. which was ridiculous.
Posted Thu, 3 May 2012 in Back Pain
Answered by Dr. Atul Wankhede 4 hours later
Thanks for asking your query.

I believe the physician did the right thing. Even if the xray was inconclusive, one needs to keep elbow immobilized for 3 weeks temporarily, and for 3 weeks more if pain persists thereon. At the end of 3 weeks if pain has not completely subsided one must take a CT scan to rule out fracture. An MRI though expensive, also shows fracture and any other like ligament or capsule tear (very likely in elbow injuries). It takes 6-8 weeks for fractures to completely heal. In children, the healing is slightly faster, hence one needs to confirm by an xray before immobilizer is discontinued. I hope the immobilization is in form of plaster of paris and not a removable-at-home type. Elbow stiffness is the main drawback in such cases and hence he must do aggressive physiotherapy after period of immobilization.

The immobilization was a good decision no doubt. Though he was jumping around the next day, it might be due to comfort of immobilization and medications. If you suspect a foul play, one can always go for a CT scan and confirm the bony status.

Its funny how women can get away with things, but if I may say, its important that your son get the best of the treatment. For this he should refrain from the sports till he recuperates.

I hope this answer was informative. If you need more help, I'm available for follow up.
Good day.
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