Arm Injury  
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Does this describe your child's symptoms?

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X-Ray - Clavicle Fracture
X-Ray - Clavicle Fracture

Bruise on Forearm
Bruise on Forearm

First Aid - Bleeding Arm
First Aid - Bleeding Arm

Nursemaid's Elbow
Nursemaid's Elbow

First Aid - R.I.C.E.
First Aid - R.I.C.E.

First Aid - Sling - How to Put On
First Aid - Sling - How to Put On

First Aid - Splint for Wrist Injury
First Aid - Splint for Wrist Injury

X-Ray - Torus Fracture of Wrist
X-Ray - Torus Fracture of Wrist

X-Ray - Normal Clavicle
X-Ray - Normal Clavicle

  • Injuries to arm (shoulder to fingers)
  • Injuries to a bone, muscle, joint or ligament

Types of Arm Injuries

  • Fractures (broken bones). A broken collarbone (clavicle) is the most common fracture of childhood.  Easy to recognize because the collar bone is tender to touch and the child is unwilling to raise the arm upward.
  • Dislocations (bone out of joint). A pulled elbow is the most common dislocation of childhood.  It's caused by an adult suddenly pulling or lifting a child by the arm.  Mainly 1 to 4 year olds. Easy to recognize because the child holds his arm as if it were in a sling with the elbow bent and the palm down.
  • Sprains - stretches and tears of ligaments
  • Strains - stretches and tears of muscles (e.g., pulled muscle)
  • Muscle overuse injuries from sports or exercise
  • Muscle bruise from a direct blow
  • Bone bruise from a direct blow

Pain Severity Scale

  • MILD: doesn’t interfere with normal activities
  • MODERATE: interferes with normal activities or awakens from sleep
  • SEVERE: excruciating pain, unable to do any normal activities, incapacitated by pain

If not, see these topics

When to Call Your Doctor

Call 911 Now (your child may need an ambulance) If
  • Serious injury with multiple fractures
  • Major bleeding that can't be stopped
Call Your Doctor Now (night or day) If
  • You think your child has a serious injury
  • Looks like a broken bone or dislocated joint
  • Swollen elbow or any large swelling
  • Skin beyond the injury is pale or blue
  • Skin is split open or gaping and may need stitches
  • Age under 1 year old
  • Bicycle spoke or washing machine wringer injury
  • Pain is SEVERE (and not improved after 2 hours of pain medicine)
  • Unable to move arm or shoulder normally (especially if someone pulled on the arm)
  • Young child and cries when you try to move the shoulder (collarbone fracture suspected)
  • Joint nearest the injury can't be moved fully (opened and closed)
  • You think your child needs to be seen urgently
Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
  • You think your child needs to be seen, but not urgently
  • Pain not improved after 3 days
Call Your Doctor During Weekday Office Hours If
  • You have other questions or concerns
  • Pain lasts over 2 weeks
Parent Care at Home If
  • Bruised muscle or bone from direct blow
  • Pain in muscle (probably from mild pulled muscle)
  • Pain around joint (probably from mild stretched ligament)

  1. Reassurance: Bruised muscles or bones can be treated at home.
  2. Pain Medicine: For pain relief, give acetaminophen OR ibuprofen as needed. (See Dosage Table). Ibuprofen is more effective for this type of pain.
  3. Local Cold: For bruises or swelling, apply a cold pack or ice bag wrapped in a wet cloth to the area for 20 minutes per hour. Repeat for 4 consecutive hours. (Reason: reduce the bleeding and pain)
  4. Local Heat: After 48 hours, apply a warm wet washcloth or heating pad for 10 minutes 3 times per day to help absorb the blood.
  5. Rest:
    • Rest the injured part as much as possible for 48 hours.
    • For pulled muscles, teach your youngster about stretching exercises and strength training.
  6. Expected Course: Pain and swelling usually peak on day 2 or 3. Swelling is usually gone by 7 days. Pain may take 2 weeks to completely resolve.
  7. Call Your Doctor If:
    • Pain becomes severe
    • Pain is not improving after 3 days
    • Pain lasts over 2 weeks
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 9/15/2011

Last Revised: 8/1/2011

Content Set: Pediatric HouseCalls Symptom Checker

Copyright 1994-2012 Barton D. Schmitt, M.D.