Hello doctor, My daughter fell from a 50 cm high bed on a carpeted floor. Three days later, her mother and I noticed that her right leg was not as active as the left one. Although she was not complaining from pain, it was very clear that she tried to avoid moving her right leg. She is 6.5 months old. We took her to the hospital and the doctor's first impression was that she is fine, but just in case she will do her an X-ray. The X-ray showed she has got a greenstick fracture in the femur bone, right above the knee. The orthopedic specialist in the hospital advised that a cast around both of her legs and her stomach to ensure maximum immobilization, and a general anesthesia must be done to her in order to do the cast. Kindly advise me according to the X-ray whether it is a must to put a full cast or a splint could be an option and is there a way to avoid the general anesthesia as she is only 6.5 months old or is it also a must to do a general anesthesia before doing the cast?
Hi. Your daughter has greenstick fracture of the distal femur. The cast which your doctor is asking to apply is hip spica. First of all, ideally hip spica should be applied under anesthesia to facilitate reduction of bone fragments but in this case, since no reduction is required, so no need to apply it under anesthesia. Secondly, since the fracture is around the knee, that is in the distal part of the femur bone, so a high above knee good cast will also do. No need to extend it to other leg and abdomen.