Childhood Diseases

Posted by: BMJ | 2012/02/05


Broken arm

Dear Doc

My almost 5y old fell off the monkey bars at school and broke his arm 16 days ago. It was a buckle break of the radius - near the wrist. He had a fibreglass cast on for 2 weeks. We were asked to return after 2 weeks to take another xray. We returned and the dr decided to remove the cast as he had 3 pressure sores. He is a sensitive child and found the noise of the blade extremely frigtening. He was histerical as they took it off. He screamed of pain in one part. This part got extremely hot as they cut it and it looked like the cotton wrapping ''melted'' into his arm. His arm was raw and had an angry rash where he complained of the heat. The arm is not fully healed, so he still has to have it immobilized. The dr did not want to put another full cast on because of his skin and also the trauma of having it removed. So the dr made a makeshift ''backsling'' which coils around his arm offering protection where the fracture is and a bandage covering all. The problem is that the badages keeps unravelling and I worry that he is ''using'' the arm to muc h -especially pressing on it etc. He is a normal active young boy. What can you suggest I do? I dont want to aggrivate this burn wound on his arm and have the trauma of removing a cast, but I am concerned that his arm wont heal with it not being fully immobilised. He does say ouch every now and again when he moves it in a certain way.

Expert's Reply



This is a bit of a Catch22 situation because your son does need a cast,but his skin is raw from his previous cast.The bandages just won't work and do not offer sufficient support to promote healing of his fracture.It would be best to take him to a clinic where dressings are done to get his skin healed as soon as possible and then he should have another cast. He will need to use a sling bandage for a day or two until his skin has healed as the cast cannot be put on over raw skin areas.

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