Fractures of the arm bone (humerus) just above the elbow (supracondylar region) are the most common elbow fracture seen in children. Unlike other parts of a child’s body, the elbow has limited ability to remodel, or straighten a bone on its own. If the bone does not heal correctly, there can be long term problems that limit elbow motion. A cast alone is not enough to hold the bone in adequate alignment in this location, so pins are used to hold the bone while it heals. The procedure used to treat this fracture is closed reduction and percutaneous pinning (CRPP), which means that the bones are manipulated into the correct position and then pins are inserted to keep them there. The pins are left exiting through the skin. They will be protected by a soft dressing and a cast or splint. The pins will be removed in the clinic. This is a very quick procedure (less than 5 seconds).
About The Recovery:
- Depending on the swelling in your child’s arm, he/she may have to stay overnight for observation. If swelling is not severe, he/she may be able to go home the same day.
- Bracing: Your child will be in a long arm cast for 4 weeks
- Weight bearing: No lifting > 5 lbs or sports while the cast is in place and for 4 weeks after the cast is removed
- Immobilization: Use either a sling or double shirt technique to keep your child’s arm immobilized against the body. In the double shirt technique, place one shirt like normal. Then, place a second shirt OVER the casted arm to trap the arm against the body. This prevents your child from rotating through the shoulder, which can cause bones to move inside the cast.
- Physical Therapy: Physical therapy is typically not needed following this surgery. If your child is still limited in motion 4 weeks after pin removal, the need for therapy will be discussed.
- First Follow Up: 4 weeks after surgery
- Back to school: When comfortable
- Total Recovery time: 2 months
- More Surgery in future? There is typically no additional surgery needed. Pins will be removed in clinic, which is well tolerated by the child and much safer than going back to surgery to remove the pins.
