An Update on Common Orthopedic Injuries and Fractures in Children: Is Cast Immobilization Always Necessary?

Children frequently visit emergency departments for injuries and fractures related to sports and recreational activities; however, the routine care of these acute minor injuries is shifting to the domain of urgent care centers. Physicians on the front lines may not have access to real-time orthopedic consultation and therefore need to be versed in the diagnosis and treatment of common pediatric fracture patterns recognizing potentially operative fractures as well as injuries that may not even require follow-up care. Unlike adults, the pediatric bone remodels quickly, and many fractures heal well without surgical intervention or even cast immobilization. Unnecessary immobilization of injuries can be detrimental to healing, and unnecessary orthopedic follow-up can be costly and straining on our health care system. This article reviews common upper and lower extremity injuries in children highlighting some of the fractures where neither cast immobilization nor urgent/emergent orthopedic consultation is always necessary.