Is it possible for a 6 yr old female 50 lbs in weight and in

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Is it possible for a 6 yr old female 50 lbs in weight and in perfect health to break her arm above the elbow by simply falling off a set of monkey bars on a swing set and landing on her elbow? There is no damage to the elbow at all or forearm. She also did not land on a hard surface such as concrete; she landed on ground softened by 3 day of rain. The monkey bars are between approx. 5 to 6 ft. off the ground. Lastly she has a bruise on her right upper chest near the collar bone that was supposedly sustained in the fall to the ground.

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It is absolutely possible. Fractures can occur without hitting a hard surface, or even occur when falling a short distance. Elbow fractures are quite common in children. The bruising may have been a result of possibly hitting her shoulder on the bar during her tumble, or when she actually hit the ground.

Fractures are very often a result of an injury sustained on the monkey bars and swings in the playground.

If enough pressure is placed at the right point of the bone, a fracture can occur.

Here is some info:

http://orthopedics.about.com/od/pediatricfractures/a/elbowfracture.htm

I thought you might appreciatw this --My son tripped on a sidewalk crack and broke his wrist when he was 7 yrs. old. On the way back from the ordeal in the ER. I turned my back to get some things out of the car for a minute. He climbed on a rock that we used in our landscaping (maybe 12" - 14" high") to look at a birds nest. He slipped off the rock backawards, fell on his elbow and fractured that. You can imagine how embarrassed I was to return to the ER within 20 minutes of leaving! I was afraid they would investigate me for child abuse! Thank goodness I worked at the hospital where he was treated and they knew me! He isjust turned 30 and is a NYPD and has overcome his clumsiness and also lived to tell everyone about it!

Kids will be be kids and unfortunately, they do get their fair share of bumps, bruises and fractures.

Please let me know if you have any other questions.

Edited by Two_Westies on June 3 2006 at 9:31 PM

Reply to Deborah's Post: She didn't break her elbow, and sustained no injury to it. She broke the humerus bone with such force it came down and actually shoved the elbow in. It was also from what I understood a clear area she didn't hit anything on the way down, and fell directly on her elbow. She broke it so bad she needs surgery to fix it.

The same applies to the humerus and surgery is often the best way to assure that the fractured bone will heal properly. By falling on her elbow, the force exerted on the arm during the fall, fractured her arm (humerus.

As it appears that she did not hit the money mars during the fall, it may be that she actually landed on her arm, as it could have folded under her and created the bruise. It may have been the secondary point her body hit during he fall.

Are your questions and concerns related to how such a serious injury could occur as a result of a fall that wasn't all that high? Or is there something else you are questioning? If you ask me specific questions, or express your concernsm I may be able to provide you with a more detailed answer.

Reply to Deborah's Post: I am VERY suspicous of this fall it wasn't from very high up but the damage is extensive. I feel that her arm may have been twisted behind her in a sort of defensive move that police officers use on hard to control perps and the bruise on her right clavical may have been sustained by someone squeezing her shoulder to force her to the ground and it broke her left arm in the process when she gave in and hit ground. Or perhaps the child or adult that did this may have fallen on top of her while this was happening. Her arm was broken with such force it actually pushed her elbow all the way in and up where the humerus should be.

What I was told is that she was swinging on the monkey bars and lost her grip and hit the ground thus breaking her left arm. She didn't hit anything on the way down and the bruise is on the opposite side of her body. This was just a standard child's swing set w/ monkey bars in the middle of a backyard on soft rain soaked ground.

Thank you, I wanted to ask you if you were suspicious, but did not want to take the liberty of being so forward as to blatantly ask you outright, so as not to offend you.

May I ask how you are related to the child and I may be able to provide you with some advice or direction.

Reply to Deborah's Post: She is my daughter... she was at her father's house when this occured.

Firstly, I would gently ask her to tell you how she fell. If the answer sounds "rehearsed" that is often the clue. If she is hesistant to discuss it at all, that may be due to the fact she is so traumatized by the injury or she is afraid to tell you precisely what has happened. Also, casually ask her who else was at the playground. If you know these people, you may be able to ascertain if anyone actually witnessed her fall.

My first advice is to request the x-ray films from the radiology dept. of the hospital she was initially treated at. Simply call, state you are her Mother and you would like the films to bring to a doctor's appointment.

Did her Dad have most arrangements with the surgeon? If so, you may want to take the films to another orthopedic surgeon as ask him or her, if the type of fracture is consistent with a fall or could it have been a result of child abuse.

Having worked the ER in my career, there is a definite pattern in fractures as a result of arm twisting.

If your husband has been abusive in the past and it has been documented with the police or child protective sevices, you do have the right to notify them of this injury.

Having an independent opiniion from another doctor would be a good start.

Also, if you can find the name of the ER physician who first saw her, you can call the ER and find out when he is next working. Do not discuss the issue over the phone. Also ask to speak to the nurse on duty. By law, if they suspected child abuse as medical personnel they are obligated to contact the authorities.

While any type of fracture can be the result of child abuse, certain fractures are much more specific for nonaccidental trauma. For example, spiral fractures are most common in child abuse cases.

http://www.aafp.org/afp/20000515/3057.html

As her Mohter, you may just want to drop the discussion at this point. Let her get over the initial trauma, but then, I would make an appointment with a child pyschologist. I would express my fears to him or her and ask if it would be possible for your daughter to be evaluated.

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