DDs wrist cast has been taken off. Arm still sore and crooked.

[PavlovtheCat]

She is 5.

She broke both bones. Ulnar was a slight angulated break, distal radius was a buckle break. No general for setting, angulated break was pushed back (or attempted) with gas and air.

She has had it in a cast for 3 weeks. 1 week with back slab and 2 weeks with soft cast. Consultant was happy that I could take this off myself on friday, but I left it a couple of days as DD had an active party, it was a reminder to her and others for her to be careful.

During the time she had it on, another child accidently stood on her arm, while it was in the cast, it hurt, i took her to gp to check it was ok, he was happy no harm done as she could still move her fingers fine.

Consultant did tell me that the arm would possibly be a little it crooked but would straighten in 3 months due to her age. Also told by the nurse to expect there to be a slight bump as a calous forms but this will be absorbed back into her bones in time.

I have taken the case off, on sunday, and her arm was very very painful and she was in tears and would not move it. She was clearly afraid and we gave her time and explained it would be a bit tender due to time in cast. By the time she went to bed she was moving it. Now, she is moving it ok.

But, it really hurts if it is touched on the site of the breaks, like she cries in pain. As it is now not protected, if it gets knocked even gently it hurts, she cannot really use it for normal things, like I can't hold her hand as it hurts too much. Is this pain normal for a while after the cast is removed?

Also, it is a bit more crooked than i expected! I know I should have been prepared, but, really it looks very bent. I can see the callous, and I am ok with that, there is a lump, but the arm bends under her wrist.

Should I get it checked, especially seeing as it was stood on, or is this ok to leave? and if I do get it checked, should that be back at fracture clinic or GP?

That really doesn't sound right. I would go to the fracture clinic and demand an xray.

ds1 broke both bones in his arm, very badly, needed op and pinning. He was a bit uncomfortable for a few hours after the cast was removed, but no pain like you describe.

do you have a minor injuries unit or anythign that would xray it if fracture clinic can't see you today? Untreated fractures can lead to nerve damage, it really needs checking pretty urgently.

I would speak up - go to outpatients clinic or something. It doesn't sound right.

I had similar experience to Chops's DS but was an adult so slower healing - was in cast for 6 weeks post-pinning. I had no pain on removal but was silently crying with the pain pre-pinning operation and they called me to say it was a terrible break and they'd have to pin it. I was so grateful to hear the specialists voice!!

the consultant did not x-ray it on the day of the fracture clinic. She had it x-rayed at A&E on the day of the break. the doctor there said she was unsure if it would need to be set properly to push the angulated break back, went to get advice, came back and said she would give it a squeeze whe n backslab was being put on. She then said not to x-ray it again to the nurse as it would be done again on the friday at the clinic. The consultant said it did not need another x-ray, he was happy that it needed nothing more doing due to her age. But. He concentrated on the buckle break, which appears simple and although that one hurts a bit, its the angulated break that was 'squeezed back' that hurts the most. I was surprised that he did not want to see her again, was happy for me to take the cast off and not return for a checkup, but then, I have never broken a bone in a limb, and nor has DH so we just guessed this was usual practice. I think I should have asked for us to come back just to get it checked out and been seen as a neurotic mum! I did not think of it then.

DH is so blase about it. He thinks I fuss over nothing, I probably do. His attitude is very much that of course it is going to hurt, she has broken it and it won't be fixed after 3 weeks. He thinks that as the consultant said to avoid activity such as bike riding and trampolining for a few weeks after cast is removed, this means there will be some tenderness and nothing needs doing to check it out.

He has just taken her to school, and has made me feel like a neurotic mother! I of course would prefer to be than anything be wrong and I tell him that whenever I 'over react', that I always hope I am over-reacting, and I dont mind a 'told you so' if it reassures me all is well.

I will take her after school to the local minor injuries unit, they have x-ray there, and if anything untoward is showing they can send us back to A&E or whereever they feel we need to go.

she can wriggle her fingers fine, i have been doing that with her daily, and she can turn her arm, but she says it hurts to turn her actual wrist, to rotate it. And she won't use it to eat with, normally uses her fork in this hand and has changed to her other hand (luckily it is her left hand, so not affecting most of the things she needs to do, like writing as she is predominantly right handed).

Please tell your DH you are not being neurotic.
DD2 has broken not her wrist, ulna in her right and radius and ulna in her left. Both times the reset them under general anaesthetic and put her in a cast for six weeks with lots of follow up in the fracture clinic.

Neither hurt and both were fully usable within a day of the cast coming off.

Sorry should have proofed, both her wrists.

No idea why the not ??

i am shocked they didnt xray more to be sure. I would go back and ask for one.

DD2 was 7 the first time and they kept checking because we had a bit of fun and games about it being straight. In the end they stuck a fat thumb on it at 3 weeks and replastered it (that did hurt).

Had she been older it would have had to be reset and pinned. I got the feeling they would have worried less if she'd been younger.

Hope your DD feels better soon

I would go back and insist on an xray! My dd had a similar break and had a full arm plaster for 8 weeks!!! It was x rayed after 6 week and the orthopedic bod said it needed to stay on longer...3 weeks is hardly any time at all!

YOu are def not being neurotic. DT1 was 6, had his xrayed in A&E, after two weeks, and then after the cast was removed.

The little boy he shared a room with on the ward, was around your dd's age, maybe 4. He had a fracture which was fixed with just manipulation, but he was also x-rayed upon cast removal.

I think it is slightly absurd that they haven't checked on it at all, and i am glad you are going to get it looked at. Good luck, and will be keeping everything crossed that she is all fine.

I am surprised too. Not that the A&E doc did not want to do another x-ray. She said she did not want to expose a young child to unecessary radiation, and that the outcome would not change anything on that day. She was of the opinion it would be done again at clinic as did I.

Dh has now expressed what his concern is. He said if they say an x-ray is required, then he accepts that is needed. But he does not want DD to have another x-ray unless it is absolutely necessary. I said I felt it was, he said my medical opinion meant jack shit as I am not a doctor! He is worried that I am going to steam in there and demand an x-ray i am when it might not be needed. He said she is such an active full of beans does not always do as she is told girl she may spend more time in hospital in her life with a broken bone so he does not want her to have lots now!

I think you have to weigh up the risks of x-ray against the risk of permanent nerve damage from an untreated fracture.

DS1 came very close to losing movement in his thumb, so although there was the risk from radiation, we were more concerned about treating the fracture.

The risk of an x-ray on an arm is tiny too, I think the odds are something like 1 in a million.

She needs another X-ray.

The idea that you shouldn't get it done because she may break other bones in future is ludicrous.

That is what explained to Dh. The way they X-ray is very good at minimising, I was impressed with how little of her arm needed to be exposed. I personally am happy with taking the risk, because it would be have been perfectly normal and acceptable for her to have had an X-ray at fracture clinic, so that would have been two X-rays which seems normal for broken wrist. We has only had one, so less than is normal, therefore this is not excessive.

Dh starts work at 4pm, we will collect dd from school, I will drop Dh off at work, and head straight to the minor injuries unit which is literally two mins a way from dh's work. I will be happier for them to tell me it is ok. Especially as her wrist was stod on, right where the break is.

Thanks all, for reassuring me I am not over reacting. I am sure it is all fine. Just need it confirmed.

pooka yes I know, he is worried about over exposure to X-rays in her life. But he is also adverse to hospitals completely. He is fortunate that we have ds as it means he now has to be at home to care for ds instead of doing hospital trips (3 in one year with dd! Not all breaks though, she bit through her tongue and fell over at school bashing her head badly).

Now he does not have to come with me, he agrees tha t I should go, as long as I don't insist on an X-ray if they don't want one. I said I will play it by ear and see what's is said. So perhaps his under reaction is his own issues coming out.

chop is his thumb ok now?

I would go back to the fracture clinic and would phone them and make an appointment. My dd broke her arm last year, broke both bones in her forearm, and had to have an op to have it pinned. She wasn't in pain after having her casts removed so it doesn't sound right to me. I would say fracture clinic rather than minor injuries.

bluebell i just called the fracture clinic. They would like her to go up at 1:30pm today as they have paediatric clinic this afternoon at that time. Good timing! I have called the school to let them know I will collect her at 1pm. DH is actually happier about this as they have her notes and are 'specialists'.

I was worried that I would be seen as making a fuss, but the nurse I spoke to was lovely! She said straight away it is better to check and make sure it is all ok and it was not a problem to take a look. She reassured me I was not making a fuss but looking out for my little girl! she is going to get the notes up for me all ready.

thank you everyone I will let you know how I get on.

Hope she's ok

She is fine! Consultant was very reassuring. He agreed it is quite crooked and not surprised I was but checked her arm thoroughly and said this level of crookedness without intervention was ok at her age. Said that it feels like it is healing/knitting together well, and happy that DD was using it ok as he was talking (she was holding on to the chair and then pointing with it). He said that it will take about 1yr to straighten, but that it would straighten on its own. I had been told 3-6 months max, but he said this was somewhat economical. Had she been older it might be a different story but she is very young and has that on her side.

He also suggested she should have come back to have her cast removed then he wrist would have been assess and this reassurance would have been given at the time. He indicated, without dumping his colleagues in it, that they often get parents in when they take off the cast themselves and see the crooked arm/their child in pain, and was very happy to see her and check it was ok, he had the original x-ray on the screen and was happy no further xray was needed looking at it now and feeling where the bones were.

He said she would need some reassurance and calpol. A little bit, but don't overdo it on either ;-D

I am glad I went. DH said 'you are are reassured, I never had any doubt' i felt like slapping him!

ooh I would have slapped him ;) I think you did the right thing, and very glad she is all ok.

Yes, dt1's thumb is fine now, though it did take a while to get full movement and sensation back in it.

Ah good, glad you have been reassured.

And I think as mums we are prone to be more anxious. When we saw the consultant, and he said that my dd would have to have an op to have the pins removed in six months, I asked about the op and my dh interrupted and said we don't need to know about that now! I could have throttled him. And he was happy to eat a full breakfast whilst my dd was in theatre, whereas I was too anxious too eat!

bluebell how is her arm now? has it made a full recovery?