Why don't they put a cast on a broken wrist in the E.R? UPDATE Post 45, pg. 3

[Disneydreaming6]

I too believe it is due to the swelling. My dd broke her wrist when she was around 6. They put a cast on it at the er, 2 days later the thing fell right off her. We had an appt with the ortho. the next day, they put one of those soft casts on it.

 

[FroggyinArk]

The main reason a splint is applied is swelling. Most orthopedic docs I work with like to put thier own casts on after the swelling has gone down. If the fracture is displaced that is another story.
It is uncomfortable. Ice ,elevation and pain medication.
Good luck! I hope your DD gets to feeling better.

actuaLLY it is rest, ice. compression, and elevation. keep it elevated and still. i broke my wrist in sept, was ina soft splint for 10 weeks . they never did cast mine.

 

[Keli]

My dd broke her arm just above the elbow (barely missing the growth plate) and they did surgery that night on her to set the bone and put some pins in.

They put her in a soft cast (an ace bandage type of thing with a sling) and they never did put a hard cast on her arm. They took the pins out a couple weeks later and put another soft cast on it until it healed.

The worst part was trying to keep her from further hurting her injured arm. If she even ran fast it worried me because all she had to do was fall with that arm under her and she'd have undid all the healing to date. So glad when that arm was healed!

 

[SueM in MN]

I used to work with a woman who had broken her arm as a child. At that time, they casted it right away, but it swelled and the cast had to be removed. When they re-casted it, it wasn't done right and they had to surgically re-break it to try to reset it. She ended up with some deformity in her arm because of it.

 

[rcraw45425]

DH is an ER doc. The hospital where he works no longer has an orthopod on call, so they have to do the same thing. A lot of the orthopedic practices just don't like to take ER call. Insurance doesn't pay that much or they get stuck with people that don't pay their bill, so I can't really say I blame the docs. As a parent it bothers me, but After hearing about the swelling issue you and others are going through I agree that it may be best to wait.

 

[buckler]

I just spoke with my neighbor who works for an ortho practice. they have 2 doctors who specialize in the wrist/hand. Since it is broken at the growth plate, I will be calling that practice tomorrow!!

YES! You definitely want a hand specialist to deal with any hand, wrist or arm injury. I was going to suggest you consult a hand specialist and was glad when I read you already were planning on it. The hand and arm are complicated, and if they aren't treated correctly, can lead to life long problems. Ortho's that undergo extra training and certification can get a certificate of added qualifications in hand surgery. You can find a hand specialist by going to:
American Society for Surgery of the Hand Doctor Locator

Edited to add:
I see you are from MA. If you live anywhere near Boston they have an excellent hand surgery training program at Harvard/Mass General. My hand doctor trained there years ago.
Mass General Hand and Upper Extremities Site

 

[yeartolate]

It is not that unusual. Since swelling frequently occurs , the extremity is splinted for stabilization, then a cast is applied when selling is down after a few days.

 

[Becky2005]

Weird. I know when my one son broke his wrist, we weren't at ER but at an urgent care. They immoblized it with some wrap (possibly a metal thing too)and gave him a sling which he was supposed to keep his wrist in the one position. It wasn't casted though, but it was more than just say an ace bandage. I don't even really know what it was -- something between the two of those.

They did tell me to go to our regular doctor. In our case, I can understand since we weren't in an ER and so I know they don't have all the stuff a regular hospital does. I then went to an orthopedic doctor that was recommended by my regular doctor & got it casted.

Once it was casted the sling was able to be removed. You would have thought they could have at least done something like that to immoblize it rather than just say put ice on it & give her Motrin.

Hope it heals fast & you can get in tomorrow.

 

[Poohlovr]

My poor grandosn has broken his arm twice in less than 6 weeks--we took him in week before last and the cast was removed from the first break--6days later, we were backgetting a new cast--he had broken the same arm in almost the same spot.

Anyway, the 1st time, we took him to the ER, where the arm was placed in a sling and splint (the splint was rather like half of a cast---it was molded for his bent arm to rest in, and then it was wrapped to his arm with an ace wrap). We were told to see a ped orthopedist; it took 3 or so days to get in. He was placed in a cast at that time.

Last week, knowing that he had broken it again, we just went to an Immediate care center, but shouldn't have even bothered with that. They did nothing, other than put his arm in a sling and tell us to take him back to the ortho (gee--I knew that).

When we got home, I put his arm back into the splint he had from the first break. Called the ortho the next day, got in that afternoon and he was placed in a new cast.

When this one comes off in 4 weeks, I hope he goes longer than 6 days before breaking it again. Sigh--12 yr old boys--what are you gonna do with them?

 

[Poohnatic]

Good luck to your DD. I know the joy of breaking a wrist. I broke my right radius and ulna and had a malunion of the joints. Two weeks in the clamshell, eight in the long arm.

Unfortunately, mine should have gone under the knife, but my ortho was out of town. His colleague manipulated it in: 20 degrees up from where it should have been Two years later, it was reset.

When I broke it, the xray tech looked at the film, at me, then back at the film, shaking his head. He also had a good laugh that I drove stick and was trying to figure out how I was going to get myself home in a clamshell!

Suzanne

 

[ducklite]

Just wanted to say I hope she feels better soon!

Anne

 

[rbuzzotta]

Thank you all for the kind words of encouragement!!

She slept good last night!! Most likely from not sleeping the night before and all the mortrin I gave her!! She looks comfortable and I hate to wake her in 15 minutes for school!! She wants to go today as she has MCAS testing and she knows I am starting a new job and doesn't want me to miss it!! Go figure that after being a SAHM for the past 7 years, I return today!!! UGH!!

My new job is part time so I will be there when she gets out of school to go to the ortho!! I just wrote a note to her teacher to call me if she is uncomfortable and I will get her immediately!! I am sure my new employer will understand and the job is 1 mile from the school!!

I am relieved that she slept well!!! Thanks again!!

 

[Kitty 34]

My son broke his ankle and didn't get a cast put on it until 6 days later!!

 

[wheeler1]

Thank you all for the kind words of encouragement!!

She slept good last night!! Most likely from not sleeping the night before and all the mortrin I gave her!! She looks comfortable and I hate to wake her in 15 minutes for school!! She wants to go today as she has MCAS testing and she knows I am starting a new job and doesn't want me to miss it!! Go figure that after being a SAHM for the past 7 years, I return today!!! UGH!!

My new job is part time so I will be there when she gets out of school to go to the ortho!! I just wrote a note to her teacher to call me if she is uncomfortable and I will get her immediately!! I am sure my new employer will understand and the job is 1 mile from the school!!

I am relieved that she slept well!!! Thanks again!!

Something similar happened to me when I went back to work as well! The 2nd day of my new job, my kids and I were heading out the door for school and then work when my son suddenly starting vomiting everywhere. I felt so bad for him and was very anxious at having to call in sick so soon...And I remember thinking it figures! This kid is never ever sick but when I actually find a job I have to call in... All was well though...

I hope she is feeling better very soon!

 

[clori]

last year my dd broke two bones in her arm last year close to the wrist but past the growth plate. One of the bones was completely separated. Honestly at first it didn't look swollen but I just didn't like dd's cry. I called the ped and told them I was coming right in. We were there within 15 minutes and the dr immediately had the nurse give her motrin then came in with the xray order for downstairs. After the xray the ped gave her more motrin and sent us to Childrens hospital. The motrin seemed to really help dd and by the time we got to the er at Childrens (driving thru Boston right before a Red Sox game) she seemed completely fine.

At the hospital dd saw a pediatric orthopedic surgeon. She didn't need surgery per se but the surgeon was able to manually manipulate the bone back into place. DD was sedated and I was sent out of the room for this. The surgeon did say she wouldn't know if it was feasible because it depended on the where the muscle was which wasn't obvious from an xray; The surgeon put a cast on dd right then. The cast while neon pink couldn't be a waterproof cast at that point. It went from her hand to above her elbow.The surgeon said she needed a different type initially but I don't remember why. For pain I was told to use motrin as needed which dd took off/on for a few days. We didn't leave the hospital until after midnight and dd slept off/on the entire next day so no way she could have gone to school but it was vacation week.

After 4 weeks in a regular cast dd was given a choice of maybe 30 different waterproof casts to wear for the remaining 3 weeks. This was a pastel colored tie dye cast that ended below the elbow. After the cast was removed she had to wear a splint most of the time for 3 weeks followed by wearing the splint a few more weeks during gross motor type activities.

 

[debster812]

You've gotten the answers you were looking for, but let me just re-iterate:

ASK FOR THE WATERPROOF CAST!!!!!!!!!! Worth every penny of out of pocket you might have to pay (2 years ago, it cost us $25 for DS's)

DS broke his wrist jumping off a swing, and was casted the next morning. We got an ortho consult the next day, and he asked if we wanted the waterproof cast.

Basically it was a liner like you see on new construction the Tyvek stuff, breathable plastic. And then a fiberglass shell (DS got bright blue). He literally spent 7 hours swimming in the ocean 2 days later with no ill effects. And there were no gyrations for showering, etc.

GET THE WATERPROOF CAST!!!!!

 

[SallyfromDE]

I would have wondered the same thing. Except that the same thing happened to me. I tripped over a dang mop in November. The ER sent me to a ortho, I had desplaced a bone in the foot. They felt a pin would be needed. Thankfully I got an appointment right away. Except that the Ortho didn't feel a pin was needed. He also didn't believe in pain meds (slows the healing). But I took what the hospital gave me anyway. The pain was too bad. I am in a non walking cast, still 6 months later. My STD leave ends today. Thank god for FMLA, I should be walking by then.

Moral of the story: Get a maid.

 

[pozey]

ASK FOR THE WATERPROOF CAST!!!!!!!!!! Worth every penny of out of pocket you might have to pay (2 years ago, it cost us $25 for DS's)

I will concur with this. Get the WATERPROOF cast!! Absolutely worth it.

 

[MomofKatie]

I had the opposite experience with my wrist break a few years ago. When I fell, I went to the Urgent Care place near my house. They did Xrays and splinted it for me, then made an appointmernt for me at an orthopedic specialist's office. I took anti-inflammatioy and pain meds that night, then went to the ortho's office the next AM.

As soon as they saw my Xrays, they told me they couldn't cast me there, since I had some type of fracture that required more complicated setting. So, it was off to the ER, where I had some heavy duty pain meds before the docs pulled my hand and wrist apart to set the bones before casting me (even on Percoset, that HURT!!). I guess I should have just gone to the ER in the first place. Worst thing- I had to have the cast all the way to my shoulder for 8 weeks. I wasn't happy with a cast that big- made everyday activities really hard.

 

[CPM]

My son just got his cast off last week. He broke it at the growth plate of his wrist.
I will advise against that Goretex cast. I have two neighbors that are doctors and they said to at least get a regular one on first, then change it to the Goretex one if it has to stay on for longer than 2 weeks. Even our Ortho Dr. said the same thing. They just work better. I forget the exact reason why.
His wrist is still a bit swollen after getting it off. They XRayed it again and will Xray it again in August to make sure it's growing properly.
I hope she feels better soon