ELBOW CONTUSION, ULNAR NERVE("Crazybone" or "Crazy Nerve" Contusion)
ELBOW CONTUSION, ULNAR NERVE
("Crazybone" or "Crazy Nerve" Contusion)
DESCRIPTIONAn ulnar nerve elbow contusion is a bruising injury from a direct blow to the ulnar nerve where it lies close to the surface at the elbow. Contusions cause bleeding from ruptured small capillaries that allow blood to infiltrate the nerve. Direct injury to the nerve causes damage even if bleeding of capillaries is not a factor. The ulnar nerve and the ulnar groove in the elbow portion of the humerus (bone of the upper arm) are involved.
Appropriate health care includes:
Doctor's care unless the contusion is quite small.
Surgery to treat the contused nerve (usually involves transferring and transplanting the nerve into muscle, where it is sutured in place).
Self-care for minor contusions or during rehabilitation following surgery for serious ulnar nerve contusions.
Physical therapy following surgery.
SIGNS & SYMPTOMSSwelling in the child's elbow--either superficial or deep.
Immediate pain in the elbow.
Shocking, electric sensations extending down to the ring fingers and little fingers.
Gradually increasing numbness and pain along the route of the ulnar nerve in the forearm and hand.
Atrophy of muscles in the hand.
CAUSESDirect blow to the elbow area from a blunt object.
Falling on the elbow.
Contact sports such as football, soccer, or hockey, especially when the child's elbows are not adequately protected; medical history of any bleeding disorder such as hemophilia; poor nutrition, including vitamin deficiency.
PREVENTING COMPLICATIONS OR RECURRENCEYour child should wear appropriate protective gear, such as elbow pads, while participating in sports if there is risk of elbow injury.
MEDICAL TESTSYour own observation of symptoms; medical history and physical exam by a doctor for all except minor injuries; X-rays of the child's elbow to assess total injury to soft tissue and to rule out the possibility of underlying fractures. The total extent of injury may not be apparent for 48 to 72 hours.
POSSIBLE COMPLICATIONSPermanent damage to the ulnar nerve, leading to disability in the forearm and hand; prolonged healing time if the child's usual activities are resumed too soon; infection if the skin over the contusion is broken.
Healing time varies from 2 to 6 weeks, depending on the extent of the child's injury and whether surgery is required or not. In a few cases, some symptoms may be permanent.
FIRST AIDUse instructions for R.I.C.E., the first letters of rest, ice, compression, and elevation. See Appendix 39 for details.
Wrap an elasticized bandage over a felt pad on the child's injured area. Keep the area compressed for about 72 hours.
Immobilize the child's arm in a sling.
Use ice soaks 3 or 4 times a day. Fill a bucket with ice water and soak the injured area for 20 minutes at a time.
Massage gently and often from the child's fingers upward to the shoulder to provide comfort and decrease swelling.
MEDICATIONFor minor discomfort, use acetaminophen or ibuprofen; topical liniments and ointments.
Your doctor may prescribe stronger medicine for pain.
Your child should begin activities slowly and stop exercise as soon as pain begins. The child can increase activity as healing progresses.
DIET & FLUIDS
OK TO GO TO SCHOOL?Yes, when condition and sense of well-being will allow.
CALL YOUR DOCTOR IF
Your child has symptoms of an elbow or ulnar nerve contusion.
Any of the following occur after surgery: increasing pain, swelling, redness, drainage, or bleeding in the surgical area; signs of infection (headache, muscle aches, dizziness, fever, or a general ill feeling); nausea or vomiting; constipation.
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.