Talk to me about a fractured radius, ulna, and hand/wrist...

[Clpretzel]

DS 6 fractured his radius, ulna, hand/wrist on a fall from the monkey bars today.  We visit the orthopedic specialist tomorrow.  We are moving in 3 weeks to another state.  Insurance and doctors will change.  I'm wondering about everything.  What to expect tomorrow at the appointment.  If he need surgery how long until that happens.  Recovery?  Anyone?  

 

I'm feeling fairly sad about it right now.  Plus I'm a wedding photographer and have a wedding tomorrow and the next day so DH will take him to the orthopedic while I shoot a wedding.    I'm sure I'll have so many questions and won't get to ask them.  What questions should DH ask?  ahhhhhh.....   

[bettyandbob]

I'd explain the move. I'd want as much needed to happen before you moved and had to look for a new doc. Hopefully the specialist can make sure most of the big stuff in treatment can get scheduled and done.

[Clpretzel]

That's really good advice!    Thanks, betty!  I'm totally not thinking right.  

[Mom2pandc]

My guess, if surgery is required, it'll be done fairly soon. You don't want bones to begin healing and then have to be "rebroken" to set them right, after that, you can expect a good 6 weeks or more in a cast. I would think most if not all of the follow up could be transferred to a new ortho person, especially if you can squeeze in the first post op visit before you move. If he broke all of that, depending on the type of fractures it may require more extensive surgery or even surgeries. I would make sure expected follow up and recovery is thoroughly discusses, but that's kind of a given :). Good luck to you and your family.

[Sara in AZ]

I'm not sure how it will work with your insurance changing. But my DD broke her elbow pretty badly last year, requiring surgery and pins, while we were visiting relatives out of state. It was no big deal at all to have the surgery done in the state where the accident happened and then have the follow up care done at home. The surgeon gave us a flash drive containing X-rays and notes from the surgery to take to the doctor at home.

 

I'm so sorry for your DS. I hope it all works out ok. The last thing you need to worry about when getting ready for a big move!

[plansrme]

My gymnast daughter broke both of those bones (but not the wrist) when she was about 5, and again when she was 9.  The second required surgery because there was a bone sticking out of her arm and because her elbow was dislocated (the surgeon inserted a rod into one of the bones), but the first did not.   She healed completely both times, and this is to a competitive gymnast's level of "completely," not just, "I can walk around and function normally."  

 

Here are my standard "to do's":

1.  If you can get a waterproof cast, do.  I think if the cast goes above the elbow, it can't be waterproof, but I could be wrong.

2.  If it isn't waterproof, Glad Press 'n Seal is your friend.  You can make a little case for it (mush it together to make a little pocket around the fingers) so that he can bathe or shower.

3.  They will tell you not to ever, ever put anything into the cast to scratch.  That is impossible.  Do not put cornstarch in there, as it will promote athlete's foot, which would be torturous, but a bamboo knitting needle is perfect.

4.  Ask whether he should move his fingers.  Both times, I affirmatively asked this and was told "yes," so I got on her about "finger gymnastics," and I believe it helped her have a quicker recovery when the cast came off.

 

The cast usually stays on about 6 weeks, though they may replace the cast in the interim.  As soon as it comes off, ask what he can be doing to regain his range of motion.  If it is not a bad break, it will probably come back completely without any PT, but ask.

 

My daughter's second break was pretty nasty as these things go, and potentially career ending, but that was 5 years ago, and she is still going strong.  When your son has a cast on his arm, you will hear story after story of how people have broken their own arms, and what you will find is that it is really easy to break a bone.  People trip over their dogs, fall off of sidewalks, run into their little brothers, fall off of scooters; you name it, someone has broken an arm doing it.  It is a pain, yes, but it will be over and fine before you know it.  

[briansmama]

My ds broke his wrist in two places this year from a failed jump skiing (radius and ulna). He did not need surgery. He had to have a full arm cast for over a month and then a half-arm cast for another month, then a brace. He was told after the casts came off that he could resume skiing and other sports as long as he wore his brace.

 

The orthopedic did need to do quite a few X-rays over the course of treatment, which I try to limit in general but couldn't in this case.

 

One thing to follow up on as it heals and they do subsequent X-rays is that as the bones repair there can often be a little pocket or cyst that develops. It's important to do the follow up X-rays for this reason. My son has a tiny spot that could be a cyst but there isn't anything they would do for it, we just need to be aware of it. The ortho did say that she's had patients with much larger ones and that is usually a recipe for a subsequent fracture, so something to be aware of.

[Clpretzel]

Update:  No surgery necessary!!!!!  He actually had one fewer breaks than the ER mentioned.  Thanks for all the input.  Now to figure out what to do with a cast all summer : )