Broken arm - can’t get seen by NHS - help please

[BrokenarmbrokenNHS]

I don’t know how to get my dd help - please could anyone advise?

My dd has an accident at school last week (Thursday). I took her for an xray at minor injuries and they said they didn’t think it was broken. A day later we had a phone call to say it was indeed broken and dd is in a lot of pain. I think it’s the radius bone as it goes into the elbow. They said they would refer to the fracture clinic and we had a choice of 2 hospitals as we are between hospitals. So I chose the more convenient one. This was on Friday on the phone.

My DD’s elbow has now been broken for 5 days. We have been referred to the wrong hospital, but I thought I will not worry about that, I will just go to it even though it’s an hour from her school. But they will not give me an appointment. I was supposed to wait to hear from them, they haven’t called. I’ve called them directly and they say she’s on some bloody list.

meanwhile my y13 dd has a broken elbow with nothing other than a sling and is shitting herself about buggering her A levels up this summer due to not being able to write and being in loads of pain.

What am I supposed to do? Why can’t we get help? This is crazy to leave a fracture for 5 days with nobody giving a shit. I foolishly thought the NHS still dealt with emergencies. I have no idea what to do. Please help.

That comment doesn't make sense, why do you think your local emergency department doesn't provide standard (A&E) facilities?

Have you taken her to A&E yet OP?

The answer is people vote for austerity and reduced taxes. The demands on the health service grow and finesse disappears. Your DD didn’t need ongoing care at hospital but GP services have deteriorated.
Fracture x rays are reviewed, fractures displace and sometimes reveal themselves after x ray, the NHS relies on patients saying if things aren’t going well.
Fracture clinic Drs are the same ones who respond to major incidents, mass casualties car crashes etc… The clinics are full of severely injured people waiting for help and people suffering over years waiting for asssistance. It’s an eye opener to experience which is why we need adequate funding for our health services…instead we are funding services that cherry pick the easier parts for profit.
I went weekly to fracture clinic across a year…people on crutches often aren’t able to get a seat, nurses sit in open areas ringing people with advice about what to do now the Dr has reviewed their x rays. It’s hectic and demand can’t easily be predicted. In the last month world supplies of bone cement to fix fractures, apply joint replacements have been restricted as the one factory in Germany that makes it has a packaging problem.

Sincerely this experience should open your eyes and not make you say you want a refund on your taxes …our health services have deteriorated as a policy to edge toward privatisation, currently free at the point of use…what would this have cost you elsewhere? Thousands with every element charged at inflated rates.

Because it would have been a waste of time.

The problem here was communication. If OP had been told when the X ray was reviewed and break identified "we have spotted a radial head fracture. These are sore but they don't need a cast. Treatment is a sling and some exercises. Fracture clinic will see you in a couple of weeks" she would have understood.

Joe public thinks broken bone = cast
This obviously isn't always the case.
In this case, a two minute longer conversation last Friday could have saved a number of days of worry for OP. It's a poor show from the NHS, but not in terms of treatment speed but in terms of communication and ensuring shared understanding and expectations.

Yes, I agree, and yes, she knows that now - but she didn't when she started posting. If your DC had been in pain with a fracture for a few days and you'd heard nothing from the clinic, would you a)post on MN, or b)go back to A&E and get some answers?

But people have helped. Advising that she wont get a cast, wait for clinic is normal etc. So this has been a useful post

It's so annoying @BrokenarmbrokenNHS Just a bit of clear communication from them would have sorted all this out.

Hi OP 👋 so sorry to hear how hard this is for you and your poor DD.

Not RTFT but when my youngest daughter broke her arm about 18 months ago in Reception at school, we went straight to A&E and were treated /triaged that day. She had an x-ray then surgery the next day. It was the University hospital in Norwich so a large teaching one, so maybe that makes a difference as they have a separate children's a
A&E and department too.

I'd push for more urgent treatment if you can, as PP have said. I'm guessing as your DD isn't paediatrics now, maybe that explains why there have been more delays etc 🤔 Hope it goes OK and she gets seen soon and treated with appropriate care. 😢❤️

Neither. I would get on to the fracture clinic.

There's zero point in going to A and E with a diagnosed broken arm that has already been referred to fracture clinic. It's not an emergency or they would have already cast it, or called her in to do so once they spotted it, if it was the sort of fracture that couldn't wait to be cast.

I've just been here with an elderly relative and slightly different break.

Fracture clinic 2 weeks later appointments - it came through but said to chase if longer as people fall through cracks but did take a week to come through.

They were admitted onto ward mainly due to concerns about cause of fall and age and affects on moblity - then discharge with little information about sling and no pain relief.

Had to wait to try for GP - couldn't get in as no GP were at nearest pratcise - did get a nurse to perscribe morphone and follow up codine by phone. Rest of family insisted not necessary as if it was hopsital would have done that .

Sling was checked only as chase equipment people for moblity - they had HCP who could come out and do that as well as set up rest of equipment.

So I would say try GP for pain relief and hope they can check sling if needed and ask when appointment with fracture clinic should be expected and chase if it's not in that time frame.

I think we got slightly better information as elderly and wider implications for moblity - but it was pretty awful.

Go to A&E this evening

Please don’t give her morphine without it having been prescribed for her. It’s an incredibly strong drug that can be fatal if given the wrong dose as it suppresses the part of the brain that regulates breathing and can lead to respiratory failure if administered incorrectly without medical supervision.

Read OPs updates

Ok seems a lot of miscommunication, but by the time you posted this thread, you knew it was a radial break thay just needed a sling for a few days then move to gentle movement right. So she doesn’t need to be seen again. So I’m not sure of all the panic?

Think I'm clear now and that you have answers. That the break doesn't need to be cast so there's no point going to A&E.

Sometimes the NHS staff are not great at communicating with people who aren't medical professionals but it sounds as though she's going to get the care she needs in the timescale she needs it in.

In the meantime, if she needs pain medication, it's GP if you can or back to the walk in if OTC painkillers aren't cutting it.

I had a similar lack of communication with the walk in / fracture clinic / small local hospital and local GP when my son broke his ankle. It doesn't work well at all but at least you now have answers.

Retired A&E doctor here.

It would be usual to put most elbow fractures in a sling unless it was displaced ( in which case it would have been spotted at the first attendance) . X-rays are usually reviewed by a radiologist or reporting radiographer to make sure subtle signs have not been missed, which it sounds like they were in this case. These findings would then be communicated to the minor injuries team who would then check if the treatment ( sling) was appropriate for this type of fracture.

If the treatment was already correct they would simply refer to the fracture clinic.

What has gone wrong here is communication. If you had been told “we have found a small fracture, we apologise that it was missed but the treatment is unchanged and she should continue to wear the sling as it is the correct treatment until seen in fracture clinic, which is likely to be x no of days away. For pain she should take xyz. If you are worried or the pain gets worse you should attend here/ A&E” you would have felt so much better about it.

That said, if the pain is bad/ she has any numbness, or you are worried you should either reattend minor injuries or go to A&E.

Because there is no facility for emergency surgery, no orthopaedic presence, no consultant presence overnight or ay weekends. It is a glorified minor injuries unit, hence attracts pretty poor staff.

The comms seem to be very poor. I think the bit they missed explaining was that the xray would be reviewed and you would be contacted but not necessarily for an appointment in person or any treatment.

The appointment you are waiting for is a follow up one (where I assume they will check for healing, and talk about physio). No one talked to you about the diagnosis or pain management which is poor. The same thing happened to a relative of mine and she was very confused. Luckily the aftercare especially the physio was very good.

Good luck for her exams.

My elbow left me in hospital in traction for 6 weeks and months of rehab ... it was quite a bad break... you just don't know!

Then it's likely a community hospital with a minor injury unit/standalone urgent care centre. It's not an emergency department/A&E

1. Stop panicking
2. You don't always get a cast for a broken elbow as its complex.
3. 5 days is OK especially as she is young - I shattered my ankle in the US, they cast it I flew back to the UK and had surgery here when I got back around 5 days later. Alot can depend if its misaligned, or needs surgery etc

I would keep trying to get hold of the hospital dept and say you want some interim advice while you potentially wait for appt. Usually with broken bones you go in, it gets aligned and it gets cast or backslabbed or whatever and then you get an appt. Elbows can be tricky but if they didn't spot it first go it may be straight forward. I think you need to speak to an ortho at the hospital - if you don't get anywhere on the phone I would head to a&e and say you want advice and explain why re not spotted originally, then phoned and referred but its left you without advice.

Break healing is 6 to 8 weeks standard. If she gets a scribe she will likely also get extra time, I would say expect the worse case and work to that as even if its out of a cast she will need physio to restore strength & Dexterity etc. Then if its not too bad it won't be so tricky

Recently spent quite a bit of time in A&E and fractire clinic and it has all been brilliant.
A&E 15 mins to be seen, 15 mins to x-ray, 15 mins to consultation.
Fracture clinic appointment, straight in, no waiting, x-ray no waiting, back to consult.
I wouldn't describe it as third world, and I don't think our trust is especially outstanding.

I broke the bone that forms the elbow and yes all they will do is sling it and follow up x-ray to ensure it healed right

Depending on the severity a cast isnt always the best option. Theyre not routinely slapped on every fracture like they used to be.

I've had two. The first time, they didn't spot the break straight away and it was only in a sling. Second time round, a plastercast was needed. (They later said pinning would have been better.)