Elbow Fracture in Children
Jordan sustained the most common type of elbow fracture in children
After jostling with a friend one evening and taking a fall, Jordan Kindred came to her parents in tears, clutching her right elbow. "She was clearly in a great deal of pain, and we were alarmed by how swollen her arm was," says Dawn Kindred, Jordan's mother. "Our first thought was to get Jordan to the nearest hospital," she recalls.
Following four hours of surgery, Dawn and Michael Kindred brought their daughter home but were concerned that Jordan was still holding her arm and very reluctant to go outdoors and play with her friends," says Michael Kindred. "We decided it was time to see a pediatric orthopedic specialist and find out what was going on."
The Kindreds contacted Howard R. Epps, MD, a board certified pediatric orthopedic surgeon, at Texas Orthopedic Hospital. "Jordan sustained a supracondylar elbow fracture, the most common type of elbow fracture in children," says Dr. Epps. "Unfortunately for Jordan, this was a Type III supracondylar humerus fracture; it was completely displaced (the ends of the bone were separated and out of alignment) with a pronounced S-shaped deformity," explains Dr. Epps. "Vascular injuries can occur in up to 15% of these fractures, as well as neurological complications. Jordan's fracture had been inadequately reduced (only partially set)," says Dr. Epps. "It was critical that I revise the initial surgical attempt to prevent severe complications or a permanent deformity to her elbow."
While the Kindreds were apprehensive about another surgical procedure, they found that the hospital's facilities were quite sensitive to pediatric concerns. "We were seen promptly, and both Dr. Epps and his staff had a warm and reassuring way with Jordan," remembers Dawn Kindred.
Jordan's surgery was scheduled for the morning after her examination by Dr. Epps. "Parents are equally anxious," says Michael Kindred, "but Dr. Epps spent a long time with us and answered all of our questions about the procedure, and Jordan's too. On the day of surgery, we were very confident that our daughter was in excellent hands."
Type III extension fractures, such as Jordan's, are caused by a fall on the outstretched arm with the elbow hyper-extended, and subtle deformities can be overlooked due to massive swelling. Because of this swelling and the child's inability to straighten the elbow, the deformity is often missed by physicians not specializing in pediatric orthopedic care. As in Jordan's case, this oversight can be limb-threatening or result in a profound deformity with disabling consequences.
The day after surgery, Jordan returned home wearing a cast with the bone stabilized by temporary pins. "The difference in Jordan's behavior was dramatic," says Dawn Kindred. "With the bone healing in the right position, her pain was gone, and she was full of life again."
Now a second grader, Jordan Kindred is an avid swimmer, tennis player and soccer star. She excels at gymnastics, but insists that school is her first priority. Why? Because medical school is tough, and she wants to help people when she grows up--"just like Dr. Epps."