The image on the left is the acute fracture through the distal radius. Image on the right, healing callous formation is visible as the fracture line starts to shrink.
Daughter’s cast came off yesterday. I couldn’t make it to the fracture clinic appointment because of work (cue the mommy guilt) but husband took a lot of pictures. Her bone is healing, there’s good callous formation, so off came the cast and no more follow-up is needed. Her little forearm has atrophied as she hasn’t used those muscles in a month and she has some bruising on the underside of the forearm where the fracture was. She insisted the discoloration was from her putting a chopstick in there to scratch an itch but really, it’s from the fracture.
I reminded her a lot today before school that she has to be careful with her arm especially in gym class. She seems to get it but the mommy in me still worries. Shouldn’t they have casted her again? Isn’t it too early for an almost-6 year old with a freshly healing bone to be running around with no cast?
Thank you for the wonderful job you did yesterday changing my daughter’s cast but we, her parents, didn’t really appreciate being completely ignored. In the future, both my husband and I would appreciate you also explaining cast care to us because although the patient, our daughter, may appear to be listening to you and nodding her head, you have to realize that a 5-year-old has the attention span of a newt and she isn’t going to remember anything you said.
Thank you for seeing my patient, however, how you managed to confuse a brain tumor with a skin condition is beyond me. Your consult note says my patient had a brain tumor removed a few years ago. Really? Are you sure it wasn’t a basal cell carcinoma? Suddenly my patient’s weakness and dizziness takes on a whole other thing when you write that she had a brain tumor. She did not have a brain tumor removed. When she pointed to her forehead and said she had a cancer removed, you should have asked her to be more specific. Getting a patient’s medical history is the first thing we learn in medical school!
I suppose it was bound to happen the way she swings around on those monkey bars. Last Friday after school I got a call from my husband that she fell off the monkey bars and probably broke her wrist.
You know that sudden feeling in the pit of your stomach you get when you know something is wrong? That’s the feeling I got when I heard my husband’s voice. He is not one to panic or think the worst so for him to say he thought it was broken I knew it was serious and I knew he was probably right.
I’ve never broken a bone so I have no idea how painful it is but I know it hurts. I’ve seen both adults and children with broken bones. When I got home and saw my daughter’s tear-stricken face and the tell-tale swelling of her little wrist my fears were realized. She was cradling her arm so carefully and refused to allow us to touch it or put it in a sling. My heart broke for her. I never wanted her to experience that kind of pain. What parent does?
The six-hour wait in the ER was long. She wasn’t allowed to eat in case she needed conscious sedation to set the fracture. It took two hours after the x-ray to see the doctor who ushered us into the orthopedic room where the casting supplies were. The ER doctor was a lovely young female resident in her second year of training and she was very calm and comforting to my daughter. I asked her how many casts she’d done that day and she smiled when she answered. She’d done five including my daughter and all were children who’d suffered injuries on the playground. My little girl was so brave and admittedly scared when the cast was being applied. She didn’t want anyone touching her arm because it hurt. Thankfully the doctor ordered some Advil and Tylenol to take the edge off a bit and it seemed to work.
She suffered what appeared to be a greenstick fracture of her distal radius.From www.kidshealth.org – a greenstick fracture is a partial fracture in which one side of the bone is broken and the other side bends (this fracture resembles what would happen if you tried to break a green stick). It is a common fracture in kids and is considered an incomplete fracture as their bones are softer than adult bones. Children’s bones are more likely to bend than break completely.
She was put into a thumb radial gutter cast because she had a bit of tenderness in one of the wrist bones as well so the ER doctor wanted to make sure to immobilize the thumb in case there was a second fracture that wasn’t visible on the x-ray. It is a temporary cast and is open on the ulnar aspect of her arm in order to allow for swelling. In a week or two we will go to the fracture clinic where she’ll have another x-ray and likely be put into a fiberglass cast for a few more weeks.
I’m thankful that she landed on her left arm as she is right-hand dominant and loves to draw. Within 12 hours of the cast being put on she had already started decorating it.
My little girl is one tough little cookie. While I never want her to experience physical pain ever again, my husband reminded me that this was an important lesson for her to learn. She is vulnerable and can get hurt. I hope she is a little more careful the next time she climbs those monkey bars again but I realize that every time she falls off, she will be determined to get back up again, even if I want don’t want her to. If I had my way, she’d never climb those monkey bars again! 😉