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Serious infectious complications related to extremity cast/splint placement in children

B Elizabeth Delasobera1, Rick Place, John Howell

  • 1Department of Emergency Medicine, Washington Hospital Center & Georgetown University Hospital, Washington, DC, USA.

The Journal of Emergency Medicine
|July 27, 2010
PubMed

Insights

Infectious complications from extremity casts, including toxic shock syndrome and necrotizing fasciitis, can be limb- or life-threatening. Early identification and prompt management, such as cast removal and aggressive treatment, are crucial for optimal patient outcomes.

Area of Science:

  • Emergency Medicine
  • Infectious Diseases
  • Pediatric Orthopedics

Background:

  • Extremity injuries requiring splinting or casting are frequent in emergency departments.
  • Patients often return with complications related to their casts or splints.

Observation:

  • Two pediatric cases of severe infectious complications from extremity casts were observed: toxic shock syndrome and necrotizing fasciitis.
  • Necrotizing fasciitis led to upper extremity amputation in a 3-year-old.

Findings:

  • A broad range of infectious complications, including life-threatening conditions like toxic shock syndrome and necrotizing fasciitis, can arise from extremity casts.
  • Early identification hinges on considering these diagnoses and performing thorough extremity inspection after cast removal.

Implications:

  • Prompt recognition and management of cast/splint infections are vital for preventing severe outcomes.
  • Vigilance is needed for water-exposed casts, which increase infection risk.
  • Suspected serious infections require immediate fluid resuscitation, antibiotics, and surgical consultation.
Abstract

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