Bone Fractures

What is a bone fracture?
A bone fracture is a break in the continuity of the bone, which needs to be put back in its proper place. The fracture can be the result of high impact, stress, or medical conditions which weaken the bone. In certain cases, there is a need to put the fractured limb in a cast, following a corrective procedure. In some cases, the fractures are open fractures, with the bone protruding out of the skin.

Spica Casting
Spica casting is a type of body casts which covers the chest, stomach, back, abdomen, pelvis and both legs. The feet remain exposed, together with the groin area. The spica cast is used in cases when the thigh bone has been injured.

How long is the cast needed? Is it painful?
The amount of time needed in the spica cast varies from child to child, but the average time is around 6 weeks. The cast itself is not painful, but your child may experience discomfort caused by the break itself. The cast is taken off in the clinic. It is a painless procedure and requires no anesthesia. Most children suffer from limited mobility in the hips after the cast is taken off. This usually goes away on its own after a few weeks.

When your child is put in a Spica cast, it is important to remember the following:

  • Keep the cast dry
  • The child should be in a diaper the whole time, to avoid any accidents. If he has an accident, use a wipe to clean the area and let it air dry.
  • A possible problem with the cast is injury to the skin, as a result of pressure from the cast. The parents should make sure to check the child's skin, every so often to prevent this.
  • Make sure your child changes position every so often
  • When you pick up your child, support his head and back.
  • Some children learn how to crawl with the cast.
  • Make sure your child's legs aren't pale and that they do not suffer from extreme heat or cold.
  • Make sure your child isn't suffering from swelling
  • Discharge onto the cast in the area of the surgical cut is normal during the first week following surgery. If the discharge is red or brown, smells bad or is continuing for several weeks after surgery – call your doctor immediately.



Call your doctor when

  • The leg has lost color, appears to be blue, swells, or if your child's level of pain worsens
  • Your child has a fever higher than 100.4 F (38 C)
  • Your child is experiencing stomach pain and vomiting



Casts
Casts help set the limb in a position which will help it heal and allow the tissue to heal. The cast also allows the limb to rest until the bones heal. The cast prevents movement of the injured area, thus preventing the situation from getting worse. The size and type of cast depends on the injured area.

The cast can be made from regular plaster or synthetic plaster. Regular plaster is slightly more pliable than synthetic plaster. If your child needs crutches, one of the nurses will teach him how to properly use them. The cast takes 24-48 hours to completely harden, so it is important to follow the following recommendations:

  • Keep it clean
  • Keep the cast dry. Cover it with a plastic bag during a shower. If the cast gets wet, it will likely destroy it.
  • Don't put anything into the cast (small toys or objects)



Movement and Support – support the limb during the first 24 hours after it is set

  • Arms: elevate it on a pillow, or use a sling
  • Legs: keep it elevated on a pillow
  • Do not lean on the cast for the first 48 hours
  • Don't lift heavy objects
  • Move the fingers or toes every once in a while
  • If the leg is in a cast, do not walk on it unless your doctor says otherwise



What to do if the child is itchy under the cast?
A bag of ice, placed on top of the cast usually helps, but make sure it is completely closed and no water drips onto the cast.

How can my child maintain mobility and muscle strength?
We recommend you begin conducting the exercises suggested by the doctor 24 hours after the cast is set.

Visits to the Clinic
The child needs to see an orthopedist based on the recommendation made by the doctor in the discharge papers. To schedule an appointment in the pediatric clinic, please call +972-2-5842111.

When to visit the emergency room:

  • If your child is experiencing acute pain, and acamol or ibuprofen does not help
  • If your child complains of a change of feeling in the limb – difficulty moving fingers
  • If exposed areas change color, lose color
  • Swelling in the cast area or exposed area
  • If the body temperature of the exposed fingers or toes varies greatly from one hand/foot to the other.
  • When a child complains of a burning sensation under the cast.
  • If the cast breaks, cracks or falls off – don't fix it on your own.
  • If your child has a high fever 100.4 F (38 C) for no apparent reason.
  • If he complains of stomach pains and vomiting
    If the cast gives off a putrid smell (could be indicative of an infection or bleeding).
  • Pressure sores
  • If the child's general condition worsens



Removing the cast depends on the type of injury and is done based on the recommendation of the doctor. Keep supporting the limb, wash it well and soften the skin with moisturizer. Keep it in an ace bandage.

If your child needs crutches or a walker or any other type of equipment, please see the Yad Sarah offices in the hospitals:

Mt. Scopus
Sunday – Thursday: 10:00 am – 1:30 pm
2nd floor; +972-2-5844485

Ein Kerem
Sunday: 10:00 am – 1:00 pm; Monday – Thursday: 11:00 am – 2:00 pm
Main Building, 1st floor; +972-2-6776260