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Tough Break!

Tough Break!

Keeping Our Kids in the Game

With fall comes not only football, but many school and recreational sports that pose injury risks to our kids, not the least of which is the chance for fractures and sprains of the hands, wrists, and forearms. Over the past several years, many changes have been made to improve care for these injuries, including the advent of new bracing and splinting technologies.

Let’s discuss a common injury, the new splints available, and the possibility of return to play while the injury is immobilized.

Your ten-year-old is playing tailback in a local league. He goes around the edge and into the secondary, gets tripped up, and extends his arm to break the fall.

Unfortunately, this leads to a buckle fracture of the radius – best described as a compression-type injury in the forearm not involving the growth plate. Radius buckle fractures can be treated conservatively with a cast for four to six weeks. Back when we parents played, this meant a plaster or fiberglass cast that would need to be kept dry, wrapped in the pool and shower, and replaced as the arm loses muscle and shrinks. Remember how scary the cast saw was? How much it itched? And no one wants to remember that horrible smell.

Enter a splint product that’s a great alternative. Exos is a multipolymer/foam bracing system that acts like a cast; however, it is removable, breathes, and can get wet without consequence, which means kids can swim with this splint protecting the arm. Our experience suggests that the patients tolerate the product much better than the old plaster and fiberglass products. There is reduced itching, much less odor, and, as the product is removable, much less skin irritation that often comes with traditional casting. And perhaps the best news for parents and young patients – no more cast saw! This type of splint can simply be reheated and molded to fit the arm as it loses bulk with immobilization, and removed when kids shower so kids can wash and apply moisturizer if the skin becomes dry or irritated. Plus, it can be cleaned and aired out to help with the smell that comes from prolonged immobilization.

The splints come in various options: short arm splint; thumb spica splints to include the thumb in more complex fracture cases; UCL thumb sprain splints; and ulnar gutter splints for injuries to the fifth hand bone (metacarpal) often seen in boxing/punching injuries. In addition, kids will like that the splint is available in multiple colors and designs: black, polka dot, camouflage, and even Spiderman.

Lastly, this state-of-the-art technology allows our patients to stay in the game. With stable fractures/sprains of the wrist and forearm, we can effectively immobilize and treat these injuries and allow the patient to continue to participate. The Virginia High School League and Virginia Independent School Athletic Association both allow participation in football and soccer if the cast/splint is below the elbow when adequately covered. Please have your physician complete the appropriate form to allow safe participation for your active athletic child.

In my own practice of sports medicine, the Exos product is used as an alternative to casting nearly every day. Our patients’ feedback – including that of my own child – suggests that the young athletes are very satisfied with the ease of use, the ease of placement, and the ease of care in large part thanks to this new technology. Most importantly, they are thrilled to continue to stay active and participate in their fall football, field hockey, and soccer games.

Steven Reece
Steven Reece, MD, is a non-operative, fellowship-trained sports medicine physician at Advanced Orthopaedics, a basketball coach, and a father.
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