De Guzman Naidin Catherine M BSN-IIA-Group1 SUMMARY

Nursing Journal Sir Aris Santos

Forearm fractures in children and adolescents are very frequent injuries, with the distal metaphysis being the most common site. Various methods of cast immobilization have been recommended in order to prevent the recurrence of angulation or displacement. A long arm cast prevents flexion and extension of the elbow as well as forearm rotation, which theoretically minimizes the risk of angulation or displacement. However, there is also a support for the use of below-the-elbow immobilization to treat these injuries, as Charnley advocated radial slabs for distal radial fractures. A short arm cast that is well molded to the normal contours of the arm should control supination and pronation. Short arm casts have the potential advantage of resulting in less temporary disability and inconvenience than long arm casts, as elbow motion is allowed. However, long arm casts theoretically are more likely to maintain reduction because elbow motion is restricted and the long wrist flexors and extensors cannot deform the fracture. Most children are active than most adults and may therefore be more likely to sustain deformity at the fracture site if the cast does not fully immobilized the joints on either side of it. In regards to the responses to activities of daily living, patients who were treated with a long arm cast missed significantly more days of school and a significantly higher percentage of them required help to dress, were unable to write, required help in school, and had difficulty with activities of daily living. The self-reported time required to regain a normal range of motion of both wrist and the elbow was 17.3 8.4 days for those treated with long arm cast and 7.3 5.1days for those treated with a short arm cast. When asked to subjectively rate the effect of the cast on activities of daily living, 94% of the patients treated with a short arm cast said that they either had no difficulty or had some difficulty that did not require assistance. In comparison, 60% of the patients treated with a long arm cast found their activities of daily living to be difficult enough to require assistance.

ANALYSIS I read a nursing journal about the comparison of long and short arm plaster cast for children who suffer from fracture. Reading this article imparted me a lot of information with regards to fractures and its management. As a nurse, the application of casts is our responsibility and this journal specified some important points in choosing and applying the right cast for the right patient. This journal recommended the short plaster cast for the reason that short plaster cast are the easiest and most convenient cast especially for children who are more energetic then full grown adults. It is mentioned in the journal that children are the most prone for fracture injuries, that is why its really needed for us nurses to master and learn the different techniques in applying casts. So that the management for fractures will be successful, because cast plays an important role in the treatment of fractures. Although it is temporary but it still play a vital role in the healing process of fracture. Another factor that was mentioned in this article is the health teaching regarding cast that we must render to our patient. We must educate them about the application and all the other stuff they need to know about cast, in pediatric patient the significant others are the one being taught by the nurse. So basically this article was all about application of cast and the informations a nurse must know about it.
References: The Journal of Bone and Joint Surgery (American) . 2006;88:1-8. 2006 The Journal of Bone and Joint Surgery, Inc. The Journal of Bone and Joint Surgery (American) . 2006;88:9-17. 2006 The Journal of Bone and Joint Surgery, Inc.Emergency Nurse Volume 17, Number 5 September 2009: 20-22The Journal of Bone and Joint Surgery (American). 2003 Volume 85-A Number 11 November 2003: 2127-2137