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Shoulder Fracture (Child)

Your child has a break (fracture) in one or more bones of the shoulder. The shoulder is made up of the collarbone (clavicle), shoulder blade (scapula), and the top of the upper arm bone (humerus). When a bone is fractured, it causes pain, swelling, and bruising.

X-rays or other imaging tests help confirm the fracture. A sling may be put on your child to hold the shoulder bones in place. In some cases, a cast or splint may be used instead. In severe cases, the bone must be realigned so it heals correctly. This may need surgery.

Until the end of adolescence, bones contain growth plates. A growth plate allows the bone to grow as the child grows. If a growth plate is fractured, there is a small chance that it will affect the future growth of the bone. You will be told whether a growth plate is involved in your child’s fracture. A growth plate fracture will be watched closely as it heals.

Fractures are uncommon in babies younger than 1 year old. This is because their bones are very soft and flexible. If your child has not had a major injury like a car accident, the fracture may mean your child has a problem with bone growth. Tests may be done. Or you may be referred to a specialist to find out if your child has another health condition. 

Home care

Your child’s health care provider may prescribe medicines for pain. Follow the provider’s instructions for giving these medicines to your child. Don’t give your child aspirin unless the provider tells you to.

General care

  • Follow the health care provider’s instructions about how much your child should use the affected shoulder and arm.

  • Make sure your child wears the sling until you are told otherwise. If it becomes loose, adjust it so that your child’s forearm is level with the ground (horizontal). Your child’s hand should be level with their elbow.

  • Apply a cold pack to the injury to help ease or control the swelling. You can make a cold pack by wrapping a plastic bag of ice cubes in a thin towel. A frozen bag of peas works well, too. As the ice melts, be careful that the cast or sling doesn’t get wet. Don't put the ice directly on the skin because this can cause damage. It may be hard to use the cold pack because most children don't like the feel of cold. Don't force your child to use the ice. Sometimes it helps to make a game of it. 

  • Hold the pack on the injured area for up to 20 minutes every 1 to 2 hours the first day. Continue this 3 to 4 times a day for the next 2 to 3 days. Then use as needed. The cold pack can be put directly on the splint or cast. 

  • Care for the sling, splint, or cast as you have been told to. Don’t put any powders or lotions inside the sling, splint, or cast. Keep your child from sticking objects into the sling, splint, or cast.

  • Keep the sling, splint, or cast completely dry at all times. You can take off a sling when your child takes a bath. Cover a splint or cast with a plastic bag and keep it out of the water when your child takes a bath. Close the top end of the bag with adhesive tape or rubber bands.

  • Encourage your child to wiggle or exercise their fingers on the hand of the injured arm often.

Follow-up care

Follow up with your child’s health care provider as advised. Your child may need follow-up X-rays to see how the bone is healing. If you were referred to a specialist, make that appointment right away.

Special note to parents

Health care providers are trained to recognize injuries like this one in young children as a sign of possible abuse. Several providers may ask questions about how your child was injured. Providers must, by law, ask you these questions. This is done to help protect the child. Please try to be patient and not take offense.

Call 911

Call 911 if any of the following occur:

  • Trouble breathing

  • Confusion

  • Very drowsy or trouble waking up

  • Fainting or loss of consciousness

  • Rapid heart rate

  • Seizure

  • Stiff neck

When to get medical advice

Contact your child's health care provider right away if any of the following occur:

  • Fever (see Fever and children, below)

  • Chills

  • Pain or swelling gets worse

  • Swollen, cold, blue, numb, burning, or tingly fingers on the hand of the injured arm

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

  • Cast or splint becomes soaking wet or soft and doesn’t dry after using a hair dryer (on a cool setting)

  • Areas under the cast become sore or have a foul odor

  • Tingling in the fingers or hand that is new or getting worse

  • Fussiness or crying in babies that can't be soothed

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 okay using a rectal thermometer, ask the provider what type to use instead. When you talk with any provider about your child’s fever, tell them which type you used.

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

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

For a baby under 3 months old:

  • First, ask your child’s health care 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

Online Medical Reviewer: Stacey Wojcik MBA BSN RN
Online Medical Reviewer: Thomas N Joseph MD
Date Last Reviewed: 3/1/2025
© 2000-2025 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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