Connect with us

POSNA Homepage POSNA.org

Dear Doctor

August 2017

Question:

On July 22, my 8 year old son broke his left wrist and I immediately brought him to our local ER. They X-rayed and temporarily splint it. On July 24 we brought him to a local orthopedic surgeon who performed a closed reduction and sugar tong splint it till yesterday, then he X-rayed again and casted it. To us, it barely looks any different and we just want to verify that our son is being treated properly. The bone was not completely alligned when it was casted. I have X-rays.

- Bridgette-Mississippi (Parent)

Answer:

(X-rays show a completely displaced distal radius (wrist) fracture).
Young children have the ability to straighten and smooth out their bones as they grow. We call this ability “remodeling.” This is something that happens only in growing children and not in adults. Remodeling is very useful when treating broken bones in children; it often allows your doctor to treat your child’s injury simply in a cast, when the same injury in an adult would require surgery. The bone initially heals in a crooked position, but in time the bone grows back to normal. Different fractures and different bones remodel differently, and it is best to consult with a pediatric orthopaedic surgeon to determine if your child’s specific broken bone will remodel appropriately. In your child’s case, the fracture is quite displaced, but he still has a lot of growing to do, and the area where he broke his bone typically remodels very well. Treatment in a cast without realigning the bone would be an appropriate treatment plan. One thing to keep in mind is that the remodeling process can take many months to a year to happen, so your son’s wrist may look crooked and he may have some limitations of motion for the next several months.

- Bridgette-Mississippi (Parent)