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Short-term after-effect of forearm cast removal in children
Kalman Katz1, Daniel Weigl, Tal Becker
1Orthopedic Surgery Unit, Schneider Children's Medical Center of Israel, 14 Kaplan Street, 49202 Petah Tiqwa, Israel. Katzzz@bezeqint.net
Insights
Children treated with above-elbow casts for forearm fractures reported a limp hand sensation post-removal. This transient feeling, common after above-elbow immobilization, requires awareness to reduce child and parent anxiety.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Pediatric Rehabilitation
Background:
- Forearm fractures are common in children.
- Casting is a primary nonoperative treatment method.
- Post-cast sensations require further investigation.
Purpose of the Study:
- To investigate hand sensation following forearm cast removal in pediatric patients.
- To identify potential differences in sensation based on cast type.
Main Methods:
- A cohort of 33 children with forearm fractures was studied.
- Patients reported hand sensations after cast removal.
- Data were analyzed against fracture and immobilization details.
Main Results:
- Children immobilized in above-elbow casts reported a limp hand sensation post-removal (17/17).
- Only one child treated with a below-elbow cast reported similar sensations (1/16).
- The difference in sensation between cast types was statistically significant (p=0.0001).
Conclusions:
- A transient sensation of hand drooping and weakness is common after above-elbow cast removal in children.
- Orthopedic surgeons and rehabilitation staff should inform families about this temporary sensation.
- Pre-removal counseling can mitigate anxiety associated with post-cast hand weakness.
Purpose:
To investigate the sensation in the hand after forearm cast removal in children.
Methods:
The study group included 33 consecutive children who were treated nonoperatively for a forearm fracture at our center over a 1-year period. The children were asked to report any sensation in the ipsilateral hand after cast removal, and the findings were analyzed against background and fracture-related data.
Results:
The patients ranged in age from 6 to 14 years (median 10.00 years). Seventeen had been immobilized in an above-elbow cast and the remainder in a below-elbow cast. All children treated with an above-elbow cast complained that after cast removal, the hand on that side felt limp, and they had to hold it with the contralateral hand. By contrast, only one child treated with a below-elbow cast reported this sensation (p = 0.0001, Fisher exact test).
Conclusions:
Orthopedic surgeons and rehabilitation unit staff should be aware of the possibility of a very short-term sensation of drooping and weakness of the hand after removal of an above-elbow cast in children and prepare the child and parents accordingly in order to lessen unnecessary anxiety.
