Sticks and Stones and Broken Bones – Casts, Splints and Ace Wraps

If your child has had a broken bone, a bad sprain or a mild sprain, your physician might use a cast, a splint or an ace wrap. Each of these offers different amounts of support and immobilization to allow the bone or joint to heal. Casts and splints can be made of plaster or fiberglass and are sometimes premade. Casts tend to go around the full circumference of an arm, leg, or foot while splints are easily removed and go around only part way. Casts are used for fractures, while splints are used for stable fractures and sprains.

Figure 1 shows a cast while figure 2 shows a splint which only goes part way around the arm.

If your child ends up getting a cast, you should do the following things;
1. Keep the extremity (arm or leg) elevated on some pillows overnight
2. Apply ice to the part that is exposed (foot or hand).
3. Make sure your child does not stick any items in the cast to scratch – casts can be itchy, but scratching can result in infection.
4. Often there will be more swelling after the cast is applied. If your child complains of worsening pain, numbness or tingling or if you notice a color change in the foot or hand that isn’t covered by the cast, you should contact your doctor immediately.
5. Keep the cast or splint dry; never submerge your cast or splint in water.
6. Do not remove the cotton padding from the cast.
7. Do not attempt to remove the cast yourself.

Tips about applying an ace wrap

I have often seen ace wraps applied in a variety of ways. The best way to apply an ace wrap for a sprained ankle for example is to have your child lie down. They should have the foot at a 90 degree ankle. Start applying the ace wrap at the toes and work your way up. Remember not to apply the ace wrap too tightly. It should provide comfortable pressure, but your child should not have worse pain or pins and needles after applying it!

Finally a word about crutches. A really amazing article on how to use crutches can be found on the aboutkidshealth site from the Hospital for Sick Children in Toronto.