From the Research
For a non-displaced radial head fracture in a 13-year-old child, the recommended treatment is typically conservative management with immobilization using a posterior splint or long arm cast with the elbow at 90 degrees of flexion for 2-3 weeks, as this approach has been shown to be effective in promoting healing and minimizing complications, as supported by the most recent and highest quality study 1.
Key Considerations
- The immobilization period should be kept relatively short to prevent elbow stiffness, which can be more problematic than the fracture itself in the pediatric population.
- Pain management should include acetaminophen (15 mg/kg every 4-6 hours, not exceeding 3000 mg daily) or ibuprofen (10 mg/kg every 6-8 hours with food, not exceeding 40 mg/kg daily) 2.
- Clinical follow-up should occur at 1-2 weeks with repeat X-rays to ensure the fracture remains non-displaced and is healing properly.
- Most children can return to normal activities within 4-6 weeks, but should avoid contact sports or activities with high fall risk for 6-8 weeks.
Treatment Approach
- Conservative management is the preferred approach for non-displaced radial head fractures in children, as it allows for optimal healing and minimizes the risk of complications.
- The use of a posterior splint or long arm cast with the elbow at 90 degrees of flexion is a common and effective method of immobilization.
- Gentle range of motion exercises should be started after the initial immobilization period, as pain allows, to promote healing and prevent stiffness.
Potential Complications
- Elbow stiffness is a potential complication of immobilization, and can be more problematic than the fracture itself in the pediatric population.
- Pain persistence or limited range of motion may require further evaluation to rule out complications, such as infection or nerve damage.
- The risk of complications can be minimized by following a conservative management approach and closely monitoring the child's progress.