Casting: Pearls and pitfalls learned while caring for children's fractures.
Casting is a routine procedure used for fracture care in the pediatric population. The purpose of this review is to provide pearls and pitfalls that our institution has learned from previous literature. When applying the cast, we recommend using cotton padding for the liner and fiberglass or plaster depending on how much swelling is expected. A well-molded cast must be applied in order to prevent further fracture displacement. Cast valving is a valuable technique that allows a decrease in pressure which prevents discomfort and complications like compartment syndrome. Preventing thermal injuries, skin complications, and a wet cast are other important considerations when caring for casts. Appropriate use of a cast saw, avoiding pressure spots, and properly covering the cast are ways to respectively prevent those complications. Lastly, patient education remains one of the most valuable tools in ensuring proper cast maintenance.
Shawn Nguyen, John Schlechter, Department of Orthopaedic Surgery, Riverside University Health Sciences, Moreno Valley, CA 92555, United States.
Shawn
S
Nguyen
Shawn Nguyen, John Schlechter, Department of Orthopaedic Surgery, Riverside University Health Sciences, Moreno Valley, CA 92555, United States.
Mitchell
M
McDowell
Shawn Nguyen, John Schlechter, Department of Orthopaedic Surgery, Riverside University Health Sciences, Moreno Valley, CA 92555, United States.
John
J
Schlechter
Cast care; Cast complications; Casting; Fracture cast; Pediatric casting; Pediatric fractures
J Pediatr Orthop. 1992 Jan;12(1):25-8
1732291
J Pediatr Orthop. 2014 Dec;34(8):e63-6
25075891
Bone Joint J. 2013 Apr;95-B(4):563-7
23539712
Hand Clin. 2005 Aug;21(3):307-16
16039442
J Orthop Trauma. 1990;4(1):85-92
2313436
J Pediatr Orthop. 2000 Mar-Apr;20(2):189-92
10739280
J Pediatr Orthop. 2014 Sep;34(6):643-6
24787307
J Bone Joint Surg Am. 2014 Jun 18;96(12):e99
24951750
J Child Orthop. 2009 Oct;3(5):375-81
19701659
J Pediatr Orthop. 1998 Jul-Aug;18(4):481-7
9661858
J Bone Joint Surg Am. 2015 Mar 4;97(5):374-80
25740027
J Pediatr Orthop. 2006 Sep-Oct;26(5):567-72
16932092
J Pediatr Orthop. 2017 Jan;37(1):74-77
26090972
J Pediatr Orthop. 2011 Mar;31(2):144-9
21307707
J Pediatr Orthop. 2012 Dec;32(8):787-91
23147621
Clin Orthop Relat Res. 1996 Jan;(322):262-7
8542703
J Pediatr Orthop. 1994 Mar-Apr;14(2):211-3
8188836
Eur J Emerg Med. 1998 Mar;5(1):37-9
10406417
Clin Orthop Relat Res. 1983 Dec;(181):191-5
6641053
J Am Acad Orthop Surg. 2008 Jan;16(1):30-40
18180390
J Bone Joint Surg Am. 2003 Nov;85(11):2207-10
14630855
J Bone Joint Surg Am. 2008 Dec;90(12):2626-30
19047707
Injury. 2005 May;36(5):588-9
15826615
J Pediatr Orthop. 2019 Jul;39(6):302-305
31169750
J Surg Educ. 2016 Jan-Feb;73(1):7-11
26385318
J Pediatr Orthop. 2010 Apr-May;30(3):248-52
20357591
J Bone Joint Surg Am. 1981 Mar;63(3):449-53
7204445
J Pediatr Orthop. 1994 Jul-Aug;14(4):508-12
8077437
J Pediatr Orthop. 2017 Dec;37(8):526-531
26683501
J Bone Joint Surg Am. 1982 Jul;64(6):907-11
7085719
J Bone Joint Surg Am. 2006 Jan;88(1):9-17
16391244
J Pediatr Orthop. 1999 Sep-Oct;19(5):683-7
10488876
J Bone Joint Surg Am. 2014 Feb 19;96(4):e31
24553900
J Pediatr Orthop. 1995 May-Jun;15(3):386-8
7790500