Casting: Pearls and pitfalls learned while caring for children’s fractures

Abstract

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.

Keywords: Cast care; Fracture cast; Pediatric casting; Pediatric fractures; Casting; Cast complications

Core tip: Casting is a routine procedure used for fracture care in the adult and pediatric population. The pediatric population present a unique set of attributes that often making casting difficult. In this article we will review different pearls and pitfalls seen while treating fractures in children which includes cast application, maintenance, and removal.