The immediate and most obvious sign that a child may have fractured their arm is severe pain, possibly accompanied by numbness in the arm and hand which could indicate potential nerve damage. In addition to the pain, if there is a misalignment of the finger, wrist, or forearm, or if there is a skin wound leading to the fracture, the child should be taken immediately to an emergency room. Not all fractures in children will result in an obvious deformity or major loss of mobility. If there is significant bruising or swelling, or if there is a significant nail-bed injury an X-ray will be needed to confirm if the bone, or bones, are broken. A doctor will need to evaluate the injury if pain, swelling, or loss of movement persists.