Q. Is it necessary to be in sling always for an arm fracture?

Hello,

Welcome to icliniq.com.

The reduction is not appropriate in this case, the bone might join in a 4-year-old child but this is certainly taking a risk. The child requires removal of the cast, reattempt at a close reduction, and application of slab for one week followed by a check X-ray elbow with forearm with wrist-anteroposterior and lateral view to confirm whether reduction is maintained or not. If a reduction is maintained then undergo cast immobilization. Children do not require a sling at all times. The role of the sling is to prevent edema of the limb by keeping it elevated and giving support. The child can play with a well-fitted cast provided there is no fall on the limb and the cast is not soft or broken. My answer is still the same. If the contact between two fracture ends is 100 % with no fracture displacement and no malalignment then the rate of bony union is high. In your child's case, bone is malaligned. Fractures may unite and later undergo a remodeling process. If a duration of three weeks has already passed since the injury, get a fresh x-ray done. If there are signs of union, continue cast. If there are no signs of union or less than three weeks then there are two options, either to wait or reattempt close reduction. Bone contact is separate for both bones. Ulna (one of the bones) is aligned with a near 95 % reduction which is satisfactory. Whereas the radius, another bone is not in contact. Bone contact is present in one view while not in the other which means there is no contact. The bone can still unite even when there is no contact, but the chances are very less. Ask your doctor to repeat the X-ray and follow up with those X-ray images to discuss the situation further. Ask your doctor whether the bones are showing signs of union or not. Please mention the total duration since the injury, slab and later cast.

Thank you.

Hi,

Welcome back to icliniq.com.

Thanks for your prompt reply. The fracture is still fresh. On the day of your follow up my recommendation is to attempt closed reduction one more time. If a better reduction is achieved chances of union are greatly enhanced. The reduction can be attempted under analgesia or under anesthesia. Confirm reduction under fluoroscopic C-arm control then apply POP (plaster of Paris) splinting. Ask your doctor for a second attempt at closed reduction as the current reduction is not satisfactory. Consider the matter open to discussion. Follow up with direct questions and doubts.

Thank you.

Same symptoms doesn’t mean you have the same problem. Consult a doctor now!

Dr. Sumit Chawla

Experience: 12 + Yrs

Orthopedician And Traumatology

---

Related Questions:
I have joint pain, anemia, swollen lymph node, and fever. Is rheumatoid arthritis the cause?

.. that you have been diagnosed with rheumatic arthritis through your blood and clinical parameters. You have been treated for anemia and arm fracture. Your blood reports say you have high inflammatory markers.   Read full

Is 20% bone union after a fracture enough in a kid?

.. is not appropriate in this case, the bone might join in a 4-year-old child but this is certainly taking a risk. The child requires removal of the cast, reattempt at the closed reduction, application of slab for one week followed by checking of X-ray el   Read full

Kindly view the X-ray and give us a second opinion.

She received a cast after the diagnosis of a fracture of the tip of the ulna ... There is a fracture involving the lower end of the radius and in the styloid process   Read full