Cumbersome casts cast off by modern medicine

updated 2:14 p.m. ET April 16, 2006

CHICAGO - The black Velcro bandage strapped on 3-year-old Ben Crotty’s left arm looks like a Rollerblader’s wrist guard, but it’s really a mini medical milestone.

It’s today’s answer to the cast.

Once almost a childhood rite of passage, plaster or fiberglass casts were the method of choice for fixing broken bones. But now, doctors around the world are increasingly shunning cumbersome casts in favor of more cutting-edge options for both kids and adults: splints, special boots, metal plates, rods and screws.

For Ben Crotty’s broken wrist, it was a removable splint.

The trend is most common among adults, who often develop swelling and pain and sometimes permanent stiffness. “We often refer to this as 'cast disease.' I say, 'Good riddance!'" said Dr. John Fernandez, an orthopedic surgeon at Rush University Medical Center in Chicago.

Better than plaster
Support for the modern technique on kids was bolstered by a Canadian study last month in the journal Pediatrics. It showed that in children aged 6 to 15 with wrist fractures like Ben’s, those who wore removable splints for three weeks had better physical function during treatment and afterward than those treated with plaster casts.

The splinted kids also escaped cast-related problems: Four youngsters sought emergency room treatment for wet casts and one for removing a pencil placed under the cast.

As an ER doctor at Chicago’s Children’s Memorial Hospital, Steve Crotty, Ben’s dad, is all too familiar with some of casts’ nastier complications.

Casts that aren’t waterproof can get moldy, and Crotty said he’s “seen maggots crawling out of casts” that kids got wet.

So when Ben’s doctor offered a splint as an alternative, his dad readily accepted.

“This is nice because he can take a bath and we just take it off,” Crotty said.

Ben broke his wrist in mid-March when he tumbled down the family’s stairs.

“I fell down and I hurt myself, and I cried and I cried and I cried,” Ben explained.

Some physicians still hesitate to put splints on young children, fearing they will remove them at will.

Ben said he didn’t like his splint “because I can’t play with two hands,” but his mother, Sheeba, said he balked whenever she wanted to remove it because he remembered his doctor’s admonition.

Ben’s splint was removed for good on April 7, three weeks after his injury.

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