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Orthopedics offers comprehensive care for children suffering from injuries and conditions that affect the musculoskeletal system, including bone fractures. Children’s Health orthopedic department treats more children with bone fractures than any other medical center in the Dallas/Fort Worth region.
If your child suffers a fracture, a physician will apply a cast to foster the healing of the broken bone. A cast will hold the broken bone in place. Casts also help prevent or decrease muscle contractions and are effective at immobilizing the area of the break, especially after surgery.
A fracture is a partial or complete break in a bone. It occurs when more force is applied to a bone than it can absorb. Your child could suffer a bone break from a fall or trauma, or as a result of a direct blow to the body. A bone break can be an open fracture (also called a compound fracture), where the bone is visible through the skin, or it can be a closed (or simple) fracture where the skin remains intact.
The outside, or hard part of cast, is made from two kinds of materials: plaster or fiberglass. Cotton and other synthetic materials line the inside of cast, making it soft and providing padding around bony areas, such as the wrist or elbow. Waterproof cast liners may be used under a fiberglass cast, allowing the child to get the cast wet.
Casts also can be used to immobilize the trunk of the body and one or more limbs. These are called spica casts. Each serves a specific purpose – for instance, to hold the hip muscles and tendons in place after surgery to allow for proper healing – and they offer several options:
One other type, a Minerva cast, is applied around the neck and trunk of the body after surgery on the neck or upper back area.
Cast types fall into two primary types: upper extremity and lower extremity. Different casts include:
As a parent, you’ll need to oversee the care of the cast to avoid re-injury, discomfort or infection. This means
If itchiness becomes a problem, you can use a hair dryer placed on a cool setting to blow air under the cast and cool down the hot, itchy skin. If your child is in a body cast, you may need to provide him or her with a bedpan or portable urinal.
Here are some other care tips:
Often, your child will be given assistive devices while his body area is immobilized. These include:
Problems with casts sometimes arise. These may need the intervention of a physician. Call your doctor if you see that your child has a fever greater than 101° F (38.3° C) or is suffering increased pain. Other red flags include
For assistance, call Children’s Health Orthopedic Department at 214-456-7697.
A fracture is a partial or complete break in a bone. It occurs when more force is applied to a bone than it can absorb. Your child could suffer a bone break from a fall or trauma, or as a result of a direct blow to the body.
A bone break can be an open fracture (also called a compound fracture), where the bone is visible through the skin, or it can be a closed (or simple) fracture where the skin remains intact.
No. The same forces that cause bone breaks in adults cause bone breaks in children. However, children’s bones are softer than those of adults and tend to buckle or bend rather than completely break. Also, a child’s bone heals much faster than an adult’s bone. The younger the child, the faster the healing occurs.
But the long-term impact of fractures can be more complex for children, as they have open growth plates (epiphysis) at the end of their long bones. This is an area where the bone grows. Injury to the growth plate can lead to limb-length discrepancies or angular deformities.
Common types of fractures that occur in children include.
If your child suffers a fracture, a physician will apply a cast to help the broken bone heal.
Casts immobilize the joint above and the joint below the area that is to be kept straight and without motion. For example, a child with a forearm fracture will have a long arm cast to immobilize the wrist and elbow joints.
Cast types fall in two primary types: upper extremity and lower extremity. Upper extremity casts include the short arm and long arm casts and the arm cylinder cast. Lower extremity casts include the short leg cast, the long leg cast and the leg cylinder cast.
A cast is designed to restrict mobility but, depending on the nature of the fracture, your child can move around in a cast, thanks to assistive devices such as crutches, walkers, wagons and wheelchairs.
As a parent, you’ll need to oversee the care of the cast to avoid re-injury, discomfort or infection. This means keeping the cast clean and dry, checking for cracks or breaks in the cast, refraining from putting powders or lotions inside the cast, covering the cast while your child is eating (to prevent spills and crumbs from entering the cast), encouraging your child to move his or her fingers or toes to promote circulation and discouraging your child from inserting objects under the cast to scratch the skin. If itchiness becomes a problem, you can use a hairdryer placed on a cool setting to blow air under the cast and cool down the hot, itchy skin. If your child is in a body cast, you may need to provide him or her with a bedpan or portable urinal.
Follow these tips for preventing infection or discomfort for a child in a body cast: