Serious infectious complications related to extremity cast/splint placement in children

The Journal of Emergency Medicine
B Elizabeth DelasoberaJonathan E Davis

Abstract

Extremity injuries necessitating splinting or casting are commonly seen in the emergency department (ED) setting. Subsequently, it is not uncommon for patients to present to the ED with complaints related to an extremity cast or splint. To present a literature-based approach to the identification and initial management of patients with possible infectious cast/splint complications in the ED setting. We present two cases of serious infectious complications arising from extremity cast/splint placement seen in a single pediatric ED: a case of toxic shock syndrome in an 8-year-old child, and a case of necrotizing fasciitis resulting in upper extremity amputation in a 3-year-old child. A wide spectrum of potential extremity cast/splint infectious complications may be seen, which include limb- or life-threatening infections such as toxic shock syndrome and necrotizing fasciitis. Simply considering these diagnoses, and removing the cast or splint to carefully inspect the affected extremity, are potential keys to early identification and optimal outcome of cast/splint complications. It is also prudent to maintain particular vigilance when treating a patient with a water-exposed cast, which may lead to moist padding, skin breakdown, and...Continue Reading

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Citations

Jun 17, 2015·Journal of Hand and Microsurgery·Trung-Hau Le ThuaWilly Boeckx
Feb 26, 2014·The Physician and Sportsmedicine·Kirstin C MonroeMatthew A Halanski
Feb 16, 2019·Journal of Pediatric Orthopedics. Part B·Gloria Hui Min ChengKevin Boon Leong Lim
Apr 13, 2019·BMC Infectious Diseases·Arne SchröderChristina Oetzmann von Sochaczewski
Jul 16, 2019·Journal of Medical Systems·Wei YanMingdong Zhou
Feb 24, 2020·International Journal of Orthopaedic and Trauma Nursing·Razieh MokhtariMahboubeh Rezaei
Jun 1, 2021·The Orthopedic Clinics of North America·Daniel F Drake, Todd F Ritzman

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