Is My Child's Arm Broken? Signs, Pulled Elbow and When to Go
Your child's arm may be broken if they won't use it, hold it still, or cry when one spot is touched — even if they can move it, because young bones bend and buckle.
Call 911 for a bent arm, bone through the skin, or a pale, cold hand. Emergency Plus in Dabouq has on-site X-ray, 24/7.
A tumble off the slide, a slip on the stairs at home, or a game of swinging by the hands that ends in tears: arm injuries are one of the most common worries for parents. The confusing part is that a child may stop crying quickly and seem fine, then refuse to reach for a toy. This guide explains why children's fractures behave differently from adults', how to tell a break from a pulled elbow or a sprain, what to do on the way, and when to call 911.
How can you tell if a child's arm is broken?
Young children can't always explain what hurts, so watch what they do more than what they say. Signs that point toward a fracture:
- Refusing to use the arm or hand, even to play or eat.
- Holding the arm still against the body, or supporting it with the other hand.
- Swelling or bruising, especially around the wrist or elbow.
- Pain on one particular spot of the bone when you press gently.
- Crying when the arm is touched or moved, or when you dress them.
- A bend, bump or odd shape in the arm.
Don't move the arm around to test it. Telling a break from a sprain is hard even in adults without an X-ray; our guide to broken bone or sprain covers the general differences in more detail.
Can a child move a broken arm?
Yes, and that is what makes children's fractures easy to miss. Children's bones are softer and wrapped in a thick, flexible lining, so they often bend or squash rather than snap. The most common types are:
- Greenstick fracture: the bone bends and cracks on one side only, like a young green branch. The arm may look slightly bent.
- Buckle (torus) fracture: the bone squashes and bulges slightly, usually near the wrist after a fall onto an outstretched hand. Swelling can be mild and the child may keep using the hand.
- Growth plate injuries: growth plates are softer areas near the ends of the bones where growth happens, and they are weaker than the ligaments around them. So what looks like a sprain near a joint in a child may be a growth plate injury, and it isn't always obvious on an X-ray. Always get persistent pain near the wrist, elbow or shoulder checked.
The good news is that children's bones usually heal faster than adults'. For more on wrist injuries specifically, see broken wrist or sprained wrist.
Toddler won't use their arm: could it be pulled elbow?
Pulled elbow, also called nursemaid's elbow, happens when one of the forearm bones slips partly out of the ligament that holds it at the elbow. It is very common between ages 1 and 4, and rare after 6 or 7. The typical picture:
- It happened after the child was lifted by the hand or wrist, yanked quickly, swung by the arms, or pulled away suddenly.
- They cried briefly, then kept the arm still by their side, slightly bent or straight, often with the palm facing down.
- They refuse to use the arm, but seem fairly comfortable as long as it stays still.
- There is no obvious swelling, bruising or deformity.
Don't try to put the elbow back yourself. A doctor needs to examine the child first to make sure it isn't a fracture, and can then usually ease the joint back with a gentle movement in a few seconds. Most children start using the arm again within minutes, and an X-ray may not be needed if the story and examination are clear. Because it can happen again, lift your child from under the armpits rather than by the hands, and avoid swinging them by the arms.
Pulled elbow, sprain or fracture?
| Feature | Pulled elbow | Sprain | Possible fracture |
|---|---|---|---|
| Typical cause | Child lifted, pulled or swung by the hand or wrist | Twist or awkward landing, usually in older children | Fall onto an outstretched hand, a fall from play equipment, or a direct blow |
| Usual age | Mostly 1 to 4 years, rarely after 6 or 7 | Older children and teenagers | Any age |
| What you see | Arm held still by the side, slightly bent; child won't use it but isn't usually crying hard | Pain and stiffness around a joint; child still uses the limb a little | Pain on one spot of the bone, refusing to use the arm, sometimes a bend or bump |
| Swelling | Little or none | Mild to moderate, with bruising | Often, but a buckle fracture may show very little |
| Where to go | Urgent care or a doctor the same day; don't try to fix it at home | Urgent care for an X-ray if pain is on the bone or the child won't use it | Urgent care for an X-ray; ER or 911 if the arm is bent, the skin is broken or the hand is cold or numb |
This table is a guide only; the symptoms overlap a lot, and an examination and X-ray are what settle it.
When should you go to the ER for a child's arm injury?
Call 911 for
- Bone showing through the skin, or a wound over the injury that is bleeding heavily.
- A hand or fingers that are pale, blue or cold.
- Numbness or loss of feeling in the hand or fingers.
- An injury after a major fall, such as from a height, or a road accident.
- A possible head, neck or back injury: don't move the child.
- A child who is unusually drowsy, floppy or hard to wake.
Go to the ER now
- An arm that is clearly bent or out of shape.
- Severe pain that isn't eased by an age-appropriate painkiller.
- A swollen elbow after a fall, and the child can't bend or straighten it.
- Any unexplained injury in a baby who isn't walking yet.
Urgent care or a doctor the same day
- A child who isn't using the arm normally after a fall.
- Pain on one spot of the wrist, forearm or elbow.
- Swelling or bruising after the injury.
- A suspected pulled elbow.
- Pain that is still there after a day or two, even if it seems mild.
Usually fine at home
- A short cry, then using the arm normally again within minutes.
- Full movement with no swelling and no tender spot on the bone.
- A small bruise from a minor knock. Get it checked if anything changes or they start favouring the arm.
Babies who aren't walking yet rarely break bones in everyday mishaps, so any swelling, pain or reluctance to move an arm in a baby this young should always be seen by a doctor, even if you didn't see how it happened. If your child also hit their head in the fall, read our guide to child head injury: when to go to the ER.
What should you do until your child is seen?
- Support the arm in the position your child finds most comfortable, with a simple sling, a folded towel or a small cushion. Don't try to straighten it.
- Wrapped ice in a cloth for up to 20 minutes; never put ice straight on the skin.
- Remove rings and bracelets from the injured side before swelling builds up.
- Nothing to eat or drink if the arm is obviously bent, until a doctor has seen them, in case they need treatment that requires an empty stomach.
- An age-appropriate painkiller such as children's paracetamol or ibuprofen, at the dose on the pack or as a pharmacist advises, unless a doctor has told you otherwise.
What happens when you bring your child in?
At urgent care at Emergency Plus in Dabouq, open 24/7 with no appointment, the doctor asks how the injury happened and examines the arm, the circulation and the feeling in the hand. If needed, they request an X-ray from the on-site X-ray department, available 24/7, so you don't have to go elsewhere for imaging. If it's a pulled elbow, the doctor may be able to ease it back during the same visit. Once a fracture has healed, our guide to return to sport after injury explains how older children can get back to play and sport safely.
Child not using their arm after a fall?
Don't wait until morning to see if it settles. Emergency Plus in Dabouq, Amman sees children 24/7 with no appointment, with emergency physicians, on-site X-ray and an Arabic and English speaking team. Call 911 if the arm is bent or the hand is cold or numb.
Call us 24/7: +962 79 247 1313Sources
- NHS — Broken arm or wrist
- AAOS OrthoInfo — Nursemaid's elbow
- AAOS OrthoInfo — Growth plate fractures
- MedlinePlus — Broken bone
- NICE NG38 — Fractures (non-complex): assessment and management
Medical disclaimer: This article is for general information only and is not a substitute for professional medical advice, diagnosis, or treatment. If you think you are experiencing a medical emergency, call 911 or go to the nearest emergency department immediately. Emergency Plus in Dabouq, Amman is open 24/7 — +962 79 247 1313.