Any doctors out there? Orthopedic question...

[formernyer]

I know this is very OT, but this is the board I post on most, so I decided to put it here...

We were at a park on Wednesday morning with my daughter's 5th grade class following her Elementary School Graduation ceremony. She and I were playing chicken on the monkey bars and she ended up falling bad...landed on her elbow. Long story short, her elbow is broken.

The orthopedist told us that it is a clean break and should heal fairly quickly. He said he expected her to be in a permanent splint for three weeks, followed by three weeks in a removeable brace. He wants to re-xray next Thursday, just to be sure it's healing correctly.

Here's what he did to her...

He took the casting material, but rather than unrolling it and wrapping it around her arm, he just molded the entire wad under her arm (to about halfway between the elbow and shoulder), then wrapped the entire arm in gauze. Once the cast on the bottom hardened, he wrapped the gauze in Ace bandages. Then he wrapped the bandages in sugical tape to hold it all down.

Can somebody tell me how this differs from just using a hard cast? Obviously, my daughter doesn't want to be in a cast at all, but she'd much prefer a "real" cast to this option. This thing seems to provide the same support and it's just as permanent, but it's easier to "pick" at, it's itchier and tighter according to her (she had a cast before when she was 5), and if she's gotta be permanently wrapped, she'd at least rather have the "novelty" of being able to have a colored cast that her friends can sign and she can keep.

Obviously, we are doing whatever the docs recommend for her, but I'm just curious as to why they would do this instead of a full hard cast? At first I thought it was for insurance reasons, but actually this option used more supplies/materials than the wrapped hard cast would have.

 

[kmjmom]

Not a Dr. here, but have unfortunately had a lot of experience with casts/splints. Usually a splint like you have described will be applied, since it allows for swelling which can be VERY painful inside a typical hard cast. The hard part protects the damaged area. I am actually in a hard cast on my leg right now and with the heat we are having, it's not fun! Good luck to your daughter!

 

[formernyer]

Not a Dr. here, but have unfortunately had a lot of experience with casts/splints. Usually a splint like you have described will be applied, since it allows for swelling which can be VERY painful inside a typical hard cast. The hard part protects the damaged area. I am actually in a hard cast on my leg right now and with the heat we are having, it's not fun! Good luck to your daughter!

Oh yeah, I knew I forgot to post part of the story

I know that they sometimes do the splints for the first few days, until the swelling goes down. However, she had very little swelling AND he said he thinks she will need the splint for the entire 3 weeks...not just the first few days.

Sorry about your leg. This weather is horrible for being stuck in a cast. I feel so bad for my daughter. She spent the summer of 2001 in a half arm cast, now she'll spend the beginning of this summer in full one.

 

[Daydreamer64]

Been there- done that! No info about the splint- BUT....

you can go to the local pet store - a big one like Pet Smart, Target also had this in their "people" first aid section but it cost more the pet smart does- it's made by the same company just has "pet" or "People" on the package- go to the pet section and find the leg wrap- it's just an ACE bandage like material that self sticks. It comes in pink, green, blue, purple .....

You can wrap her splint in this- then she can have everyone sign it with a marker - My Dh works in a hospital and his friends told him that this is the same stuff that they wrap the casts in after they splint/plaster the arm at the orthos except it's removable- when she gets hot or tired of the color just peel it off and she can put a new color on the arm- she could even change the colors according to what she's wearing that day.

This goes over the current cast- so when she wants a change, she can peel it off and no worries about moving or damaging the splint that is supposed to stay on the arm.

My boys always prefer the splint to the plaser cast , boys, what are you going to do with them - I've had both- bad ankle - and I prefer the splint as it really doesn't seem as hot as the plaster- the last plaster cast that I had, I couldn't take it after 4 weeks so I worked with my DH's tools and took the darn thing off myself- oh what a relief- then the next day the orthos office said that my appointment the next week would have to be remade because he had a heart attack and all of his appointments were cancelled for the time being- ! I just used the walking splint/shoe for a few weeks and all was good with me-

Oh, and aahhh- you may not want to keep the cast as it will have bits of skin on it- her arm is going to be very dry and peel, and bacteria can grow on the cast wrap as people sweat and, well, we thought that we would like to keep our first cast too but as soon as it came off it smelled funky and was just gross- so maybe you could take a pictures of her cast and keep those- just a thought

 

[kmjmom]

Yikes! I can't say I'd be bold enough to remove my own cast, but I don't mind snuggling up to the AC! I like the idea of the colorful tape. When I inquired about the color for my cast the response was,"we have white, white and white!" Pretty boring!

 

[Daydreamer64]

Oh, it was really funny now looking back at the situation- the cast person didn't use enough casting material and having been through this so many times, I suggested that she add more- I would pay extra for it but I got "the look" and no extra material

I made it for weeks but it was in August and the heat was terrible- I got caught in a rain storm and it's not a good idea to be wet in there. After trying the blow dryer and poking paper towels into the cast I just lost it and went crazy, I started to bark orders for the boys to get me the tools, a garbage bag and the broom- they were fasinated and were happy to help Mom

- that thing was coming off no matter what DH came home to two boys helping Mom liberate the leg- there were pieces of cast dust and chunks all over the floor, we had all worked up a sweat - all I could get were plyers, a hammer, and a flat head screwdriver- and YES- if a person is determined enough, they can accomplish ANYTHING-

It felt so good to be done with it and I cried I was so happy to be free- Dh said he saw a side of me that he hadn't seem yet in over 17 years of marriage - he said I was a driven women and it was obvious that nothing was going to get in my way until I was done.

 

[formernyer]

The colored tape is a cute idea!

I guess it makes sense that having the entire arm in the casting material could be hotter than just having it on the underside, but according to daughter, itching is the issue and not overheating. Admittedly, she's never had a plaster cast and I bet they are hotter than the fiberglass type that she's had. Last time, the entire cast was fiberglass. The splint she has this time is also fiberglass.

 

[formernyer]

Forgot to respond about keeping the cast...

Her last cast did stink when it was removed, but I just put it outside for two days to air and then it was fine.

 

[Daydreamer64]

My casts have always been plaster casts because it's my ankle that needs to be casted so the foot also gets casted up to the edge of the toes- another reason that the cast smelled even though I never have a foot odor problem- weeks of walking in/on the cast, sweating in the cast, and getting sprinkled with water during rainy times made it a science project to be studied. The fibercast didn't last a week and I had to be recasted with plaster because of walking, the cast started to "bend" at the ankle and cracked across the bottom which caused me lots of pain-

I hope she get feeling better soon- it's not any fun to have a cast much less not having the one that you wanted-

 

[smfritz03]

My SIL broke her elbow a few mths ago. They put the same type of cast on her because they wanted her to still have small amts of range of motion that she wouldnt have gotten in a hard cast. She was told it would take at least 6 mths to fully heal from this break. She still has pain but she was able to move it small amts daily and she had a pretty nasty break.

 

[Ciciwoowoo]

My son broke his elbow and they did the same thing for him. Actually, doctor #1 gave him a full cast. He cried about how much it hurt! After a few days of this, I took him to doctor #2. Doctor #2 gave him the half cast, which was much more comfortable.

I wish I could remember the reason the doctor gave us for the half cast, but I do remember he said it was the recommended treatment for this type of injury now. (Doctor #1 was old, doctor #2 was young)

 

[formernyer]

My son broke his elbow and they did the same thing for him. Actually, doctor #1 gave him a full cast. He cried about how much it hurt! After a few days of this, I took him to doctor #2. Doctor #2 gave him the half cast, which was much more comfortable.

I wish I could remember the reason the doctor gave us for the half cast, but I do remember he said it was the recommended treatment for this type of injury now. (Doctor #1 was old, doctor #2 was young)

A half cast? That wouldn't even cover the broken bone (on the elbow)! Did you mean a splint like I described above?

 

[Green Tea]

DS broke a bone and they did a spint thing, wrapped like you describe. I HATED it. For a kid, just put them in something they have no control over. If it can be removed, it will be removed.

 

[CantWaitToGo2007]

I know this is very OT, but this is the board I post on most, so I decided to put it here...

We were at a park on Wednesday morning with my daughter's 5th grade class following her Elementary School Graduation ceremony. She and I were playing chicken on the monkey bars and she ended up falling bad...landed on her elbow. Long story short, her elbow is broken.

The orthopedist told us that it is a clean break and should heal fairly quickly. He said he expected her to be in a permanent splint for three weeks, followed by three weeks in a removeable brace. He wants to re-xray next Thursday, just to be sure it's healing correctly.

Here's what he did to her...

He took the casting material, but rather than unrolling it and wrapping it around her arm, he just molded the entire wad under her arm (to about halfway between the elbow and shoulder), then wrapped the entire arm in gauze. Once the cast on the bottom hardened, he wrapped the gauze in Ace bandages. Then he wrapped the bandages in sugical tape to hold it all down.

Can somebody tell me how this differs from just using a hard cast? Obviously, my daughter doesn't want to be in a cast at all, but she'd much prefer a "real" cast to this option. This thing seems to provide the same support and it's just as permanent, but it's easier to "pick" at, it's itchier and tighter according to her (she had a cast before when she was 5), and if she's gotta be permanently wrapped, she'd at least rather have the "novelty" of being able to have a colored cast that her friends can sign and she can keep.

Obviously, we are doing whatever the docs recommend for her, but I'm just curious as to why they would do this instead of a full hard cast? At first I thought it was for insurance reasons, but actually this option used more supplies/materials than the wrapped hard cast would have.

I'm not a doctor, but I am an x-ray tech in a busy orthopaedic practice. Our patients that have elbow fractures (kids that aren't surgical anyway) are usually in a splint for a couple of days. It usually takes us a day or so to fit them into the office schedule after they are seen in the ER. If they aren't surgical most of the time they are put in a fiberglass cast when they come to see us, providing there is not a lot of swelling. If there is still quite a bit of swelling they will come back the following week to be casted. Simple non-displaced fractures are x-rayed 1 week after coming to our office in their cast(to make sure the fracture has not moved) and then usually 2-4 weeks after that they come back and have another x-ray out of the cast. If the fracture has not healed they are usually put back in the cast for another 3 weeks. If the fracture was bad enough to require surgical fixation then they are usually in the cast for 2-3 months with a cast change about halfway through.

Hope this helps. Make sure she doesn't get the inside of the splint or cast (if she is later put in one) wet. If it gets wet (were talking falling in the pool wet) it needs to come off within 24 hours or her skin will start breaking down fast. We just had this happen with one of the kids we are treating. He didn't tell his parents for a week he accidently got it wet because he thought he would get in trouble.

 

[formernyer]

Thanks for all the replies.

 

[kaytieeldr]

The hard part protects the damaged area. I am actually in a hard cast on my leg right now and with the heat we are having, it's not fun! Good luck to your daughter!

Cornstarch or baby powder, and a turkey baster.