![]() ![]() They need specialist application and removal after 4-6 weeks. They may completely encircle the arm up to or sometimes above the elbow or they may be incomplete (a backslab) to allow swelling to subside. Rigid casts are usually made from plaster of Paris or fibreglass and are customised to fit the individual child. ranges from full immobilisation using a rigid cast to simple splinting with a soft or elasticated bandage. For example, medicines, surgery, psychological and physical therapies, diet and exercise changes. Depending on the type of fracture, treatment Something done with the aim of improving health or relieving suffering. Examples include a drug, surgery, exercise or counselling. Most wrist fractures in children do not need surgical intervention A treatment, procedure or programme of health care that has the potential to change the course of events of a healthcare condition. Less frequently there may be a fracture of the distal end of both forearm bones (radius and ulna) but fractures of the ulna alone are rare. A serious clinical situation arises if the fracture is ‘open’, meaning that the bone is exposed through the overlying skin and tissues. Fractures may involve the growth plate of the bone, something that is commoner in older children. These fractures can cause significant deformity and are unstable. Other injuries may lead to a complete break. Buckle and greenstick fractures are commoner in younger children. Another type of radial fracture in children is the ‘greenstick’ fracture where the bone breaks only on one side and bends towards the opposite side. These fractures tend to be stable but cause deformity and pain. Most of these fractures are ‘buckle’ or ‘torus’ fractures where there is no clean break in the bone but a compression or ‘buckling’ of the cortex (the outer layer of the bone) ( Randsborg, 2012 Thimmaiah, 2012). They account for an estimated 500,000 UK emergency department attendances per year, with around 3% needing hospital admission ( Shah, 2015). Wrist fractures involving the radius (one of the bones in the forearm) are the commonest fractures in children and usually happen after falling onto an outstretched arm. ![]() Yet another child with a buckle fracture was given a soft splint, which was removed at home after just three weeks.ĭifferent treatments for the different kinds of wrist fracture – what’s the best in each case? Ouch! A nasty wrist fracture with both radius and ulna broken. A colleague’s child fractured both radius and ulna (see images below) and, after manipulation under anaesthetic, was placed in a full-arm fibreglass cast, flexed at the elbow. Each time she was given a rigid cast (yellow and red) for six weeks. I won the award for having the most accident-prone child, who, on two separate occasions, sustained a wrist fracture whilst rollerblading : a greenstick fracture the first time and a complete break the second. Take-home pointsĪ recent conversation in the office revealed the diversity of childhood wrist fractures and the different ways there are of treating them. There are different types of studies used to answer research questions, for example randomised controlled trials or observational studies. The blog now includes the results of the FORCE study An investigation of a healthcare problem. Revised and republished: 03 February 2022. Page originally published: 18 January 2019. In this blog, Lynda Ware, our Senior Fellow in General Practice, looks at evidence and practice for different treatments for wrist fractures in children. ![]()
0 Comments
Leave a Reply. |