Buckle (Torus) Fracture of an Arm

Home care

Follow these guidelines when caring for your child at home:

• Your child will be given a splint or cast to keep the arm from moving. Keep your child's arm elevated to reduce pain and swelling. When your child is sitting or lying down, keep the arm above heart level. You can do this by placing the arm on a pillow that rests on your child’s chest or on a pillow at your child's side. This is most important during the first 2 days (48 hours) after the injury. Be sure that the pillows don't move near the face of an infant or toddler. Never leave your child unsupervised.

• Put an ice pack on the injured area. Do this for 20 minutes every 1 to 2 hours the first day for pain relief. You can make an ice pack by putting ice cubes in a plastic bag that seals at the top. Wrap the bag in a thin towel or cloth before using it. As the ice melts, be careful that the cast or splint doesn’t get wet. You can put the ice pack inside the sling and directly over the splint or cast. Keep using the ice pack 3 to 4 times a day for the next 2 days. Then use it as needed to ease pain and swelling.

• Keep the cast or splint completely dry at all times. Have your child bathe with the cast or splint out of the water. Protect it with a large plastic bag, taped or rubber-banded at the top end. If a fiberglass cast or splint gets wet, you can dry it with a hair dryer on the cool setting.

• You may give your child acetaminophen or ibuprofen to control pain, unless another pain medicine was prescribed. If your child has chronic liver or kidney disease, talk with the health care provider before using these medicines. Also talk with the provider if your child has had a stomach ulcer or gastrointestinal bleeding. Don’t give ibuprofen to a child younger than 6 months of age.

• Don’t put creams, lotions, or objects under the cast. If itching doesn't stop, call your provider.

Follow-up care

Follow up with your child’s health care provider as advised. This is to make sure the bone is healing the way it should. If your child was given a splint, it may be changed to a cast at the follow-up visit.

When to get medical advice

Contact your child’s health care provider right away if:

• The cast or splint cracks.

• The plaster cast or splint becomes wet or soft.

• The fiberglass cast or splint stays wet for more than 24 hours.

• Tightness or pain under the cast or splint gets worse.

• Fingers become swollen, cold, blue, numb, or tingly.

• Your child can’t move the fingers on the injured arm.

• Skin around the cast becomes red, swollen, or irritated.

Also call your child’s provider right away if your child has a fever (see "Fever and children" below) or chills.

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The health care provider may want to confirm with a rectal temperature.

• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

• Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use a rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the provider what type to use instead. When you talk with any health care provider about your child’s fever, tell them which type you used.

Below is when to call the provider if your child has a fever. Your child’s provider may give you different numbers. Follow their instructions.

When to call a health care provider about your child’s fever

For a baby under 3 months old:

• First, ask your child’s provider how you should take the temperature.

• Rectal or forehead: 100.4°F (38°C) or higher

• Armpit: 99°F (37.2°C) or higher

• A fever of ___________as advised by the provider

For a child age 3 months to 36 months (3 years):

• Rectal or forehead: 102°F (38.9°C) or higher

• Ear (only for use over age 6 months): 102°F (38.9°C) or higher

• A fever of ___________ as advised by the provider

In these cases:

• Armpit temperature of 103°F (39.4°C) or higher in a child of any age

• Temperature of 104°F (40°C) or higher in a child of any age

• A fever of ___________ as advised by the provider