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Caregiver experience of at-home softcast removal following paediatric trauma

Jingjing Wang1, Katie Patterson Hughes2, Joanna Marilyn Stewart Aithie2

  • 1The University of Edinburgh Medical School, 49 Little France Crescent, Edinburgh, EH16 4SB, United Kingdom.

Injury
|August 24, 2025
PubMed

Insights

At-home softcast removal for pediatric fractures is safe and feasible, even for displaced injuries. Most families reported positive experiences, and this practice reduced clinic visits by over 50%.

Area of Science:

  • Pediatric Orthopedics
  • Fracture Management
  • Healthcare Service Delivery

Background:

  • Circumferential softcasts are used for pediatric fractures requiring manipulation.
  • Traditional follow-up protocols involve routine clinic appointments.
  • Alternative models for cast removal are being explored to improve efficiency and patient experience.

Purpose of the Study:

  • To assess the safety and feasibility of at-home softcast removal in children with displaced fractures.
  • To understand the caregiver experience associated with at-home cast removal.
  • To evaluate the impact of this practice on healthcare service utilization at a tertiary center.

Main Methods:

  • Retrospective analysis of pediatric patients (<16 years) undergoing at-home softcast removal without planned follow-up.
  • Data collected included demographics, fracture characteristics, manipulation details, and re-attendance rates.
  • Caregiver satisfaction and experience were assessed via telephone questionnaire; cost analysis was performed.

Main Results:

  • 77 caregivers completed the survey; mean patient age was 7.6 years.
  • 52% of injuries underwent manipulation; 16.9% of patients re-attended with cast issues.
  • 83.1% of caregivers found removal easy, 75.3% were satisfied, and 71.4% would recommend it; >50% reduction in clinic attendances and £22,600 annual savings.

Conclusions:

  • At-home softcast removal is a safe and feasible option for pediatric fractures, including displaced injuries.
  • The majority of families reported positive experiences, though patient education is crucial for universal success.
  • This approach significantly reduces healthcare service demand and associated costs.
Abstract

Keywords:
Caregiver experiencePaediatric orthopaedicsQualitative researchSoftcast removal

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