Executive Editor: Fergal Monsell General Editor: Chris Colton

Authors: Andrew Howard, Theddy Slongo

Pediatric distal humerus 13-E/4.1M Cast Immobilization

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Postoperative care

If the child remains for some hours/days in bed, the hand should be held in an elevated vertical position in a roller towel to reduce swelling and pain.

After discharge from hospital, the arm should be held in a sling for immobilization.

Note: In any case of elbow immobilization by plaster cast, careful observation of the neurovascular situation is essential both in the hospital and at home.

See also the additional material on postoperative infection.

It is important to provide parents with the following additional information:

  • The warning signs of compartment syndrome, circulatory problems and neurological deterioration
  • Hospital telephone number
  • Information brochure

Cast removal

Radiological control should be scheduled according to the estimated healing time. The timing of this depends on the age of the child and the type of fracture. Any x-ray to assess healing must be performed out of the cast.

In case of delayed healing, a posterior plaster splint, or manufactured splint, might sometimes be required for an additional 1-2 weeks.

v1.0 2016-12-01