Baby & Toddler / 30 March, 2021 / Leo Bamford
I’m almost 40 and until 2020 had never seen a broken bone! That might sound strange having two older brothers and being a tomboy myself as a child, but it’s true. A broken finger maybe but never an arm or a leg. I used to look at friends’ casts at school and be envious of all the scribbles and doodles that people would make, but never had one myself.
So after going through some serious trauma surgery with my youngest over lockdown, I wanted to share my story to try and stop it from happening so often. How I wish I had read something like this on My Baba before it happened to us. I hope if one of your children ever break something, you will remember this post and my advice.
It’s 2020 lockdown and the sun is shining, I’m so happy to have a trampoline in the garden and we literally spend hours as a family bouncing. I hear myself telling them to, ‘be careful! Please don’t jump too close to each other. I DO NOT want to end up at A&E in the middle of a pandemic!’. Fast forward to Easter Sunday and we’re all happily playing outside in the sun waiting for lunch, which my husband is making in the kitchen.
I’m just taking my shoes off while the kids bounce up and down and then my youngest starts to cry. As my eldest jumped up, it looked like my youngest put his arm out and ‘snap’. I ran to him, had a look and immediately thought it was broken. It was almost arched but hard to tell. It was so slight. He cried for half an hour, then came and ate lunch on my knee and then fell asleep on my chest. None of us wanted it to be broken and needing a trip to the dreaded Corona-filled A&E.
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When he awoke, he wasn’t in pain anymore but it just didn’t look 100%. At any other point, I would have run to A&E but the numbers of Covid cases were terrifying and my instinct said to wait and see. He wasn’t in any pain.
Just before bed, I called the doctor on FaceTime and he said we needed to get to A&E because it was definitely broken and that even though it wasn’t painful now, it would be later.
Off to A&E! The doctor saw us quickly and we had some X-rays done. He said that it was a ‘green stick fracture’ and that he needed to manipulate it back into position. We had to move to the high-risk part of the hospital for him to have liquid morphine up his nose and then quickly manipulated it back into place, before casting it there and then. The cast was hard on the front and back but soft on the sides. The doctor told us that he couldn’t count how many broken bones he had dealt with as a result of trampoline accidents, it was that common.
X-ray after first break and after trampoline accident
My little one was extremely brave but it was awful to see him in pain. It was also now about 10 pm and he was so tired.
Another X-ray to make sure it was straight and we were sent home.
I was told that children’s bones fix very quickly and that the cast could come off in three to four weeks. A hospital administrator, who had been looking at the X-rays with the doctor, said it didn’t really need to be cast and that if we left it and did nothing at all, it would fix itself!
Three weeks later I got a call from the lovely doctor who had helped to say that they had re-looked at the old X-ray and thought that, due to Covid, it would be safer for me to cut the cast off at home.
I waited an extra week and cut it off after four weeks.
In my gut, after cutting it off, I felt it looked exactly the same but the doctor was happy and he said it would be as good as new, just don’t trampoline for a while. I was just thrilled not to take him back to hospital again.
This was my biggest mistake, I should have insisted I take him back for a check-up and have another X-ray. I didn’t know then, but the chance of refracture is extremely high. No-one mentioned this to me and I feel like a fool for not knowing deep inside.
I didn’t give it another thought, how stupid! We went on with our lives and didn’t look back. I remember looking in the cupboard at the sling and waterproof cover for his cast and chucking them in the bin. Never did I think it could happen twice!
Ten days later, we were in the garden and he was running behind me on the lawn. He tripped and landed on the terrace – hands breaking his fall. I heard a cry that I hope I will never in my life hear again, it was more like a badly wounded animal.
I picked him up and to my horror, his arm was bent like a drinking straw. It was so distorted, my immediate reaction was to straighten it. I couldn’t remember my Red Cross training but my mother’s instinct said to do what the doctor had done a month before and straighten it.
Before trauma surgery, the arrow is to show the doctor which arm to operate on!
He was in complete shock but it was quick. I rushed him inside terrified that I had done some long-term damage by straightening it. I kept asking him to wriggle his fingers and he could not.
I quickly made a homemade muslin sling and rushed to A&E again.
I won’t go into details, but they had to re cast it there and then and after many more X-rays, they told us they would operate under trauma surgery in the morning. We went home and I slept on his floor, amazed that he managed to sleep at all. We left home at 6 am the following morning and when we arrived, they told us that this time it was not a simple green stick fracture, but a serious break!
There were two options, one would be to make incisions and put in a plate which would fix the problem and would need further surgery to remove. The other option would be to insert a K Wire through the bone which would need removing, probably as an out-patient but not under aesthetic.
Second break / re-fracture and arm after wire inserted
The operation was horrific, they had to saw through all the new bone to make room for the massive, thick wire which stuck out from the skin under his cast for 6 weeks until they removed it. He also choked on the incubation tube which caused an emergency, doctors and nurses rushing to theatre.
Covid had made everything crazy and new rules meant that he had to be woken in theatre away from me by doctors and nurses in full PPE. As you can imagine, by the time I had broken my way into the recovery room, quite literally, he was in a terrible state.
A week later, he couldn’t move his fingers, so I went back to have the cast re-done. I was shocked to see the state of his little arm underneath and the thick wire sticking out. The cast has been too tight and his arm was black and blue.
This is when I called on Mr Maxim Horwitz. Running My Baba, I have been incredibly lucky to be able to call on specialist experts in all fields, and our editor, Ellie, put me in touch with Max, who is the Consultant Orthopaedic Hand and Wrist Surgeon working at both the Wellington and the Chelsea & Westminster hospitals.
Post op re-cast
He told me over video conference, that the first cast should have been on for a minimum of six weeks and we should have been told to take things VERY easy and watch his every move. I told him that that was easier said than done with a toddler, but he was very frank with me and told me that the chance of refracture in toddlers is extremely high. I felt so stupid for not flagging this up when the first cast came off. It seemed so logical and sensible now, but everyone was all far more worried about Covid and I had been told that ‘children’s bones are not like adults and they take no time at all to heal.’
I also had the privilege of being introduced to Mr. Ramon Tahmassebi, who is the Consultant Hand Wrist and Upper Limb Surgeon at the Fortius Clinic. He was so incredibly helpful and was texting me back and forth at all hours of the day, reassuring me and giving me help and advice.
The new cast helped and six weeks post-op we were asked back. They said that it would be very traumatic to take the wire out there and then and that they would have to do it under aesthetic.
X-ray before the cast was taken off
We were booked in and another long operation awaited us.
Again, I literally had to force my way into the recovery room and console him. He had another full cast and this time they said to come back in a couple of weeks to have the cast-off.
Finally, Covid protocol now allowed us to book appointments, so I immediately booked in to see Mr. Horwitz in London.
The first thing he did was to send us for an X-ray and after studying that, he was happy that the cast could come off. It was pretty traumatic taking it off after two breaks and my son walked around the room with his arm like a claw, not wanting to even look at it or touch it.
We then went to see Mr. Howitz’s physio, who showed us a few exercises to do and also made a special cast that was molded to his arm and fastened with Velcro. This was to be used in situations where we thought he could hurt himself. When he went to nursery, we left it on all day. I know hindsight is always the best sight, but how I wish I had done more research after the first break and found something like this, just to give his little arm a bit of protection after the cast came off.
So now, almost a year on from the first break and we’re left with a reminder in two thick scars that cover the length of his forearm and my wincing every time I see a child go near a trampoline. If you’re thinking of buying one, maybe google how many accidents happen on trampolines before you do so.
Cast off and X-ray 5 months post first break
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For scarring aftercare, a paediatric skin specialist recommended using these products:
Night: (note: you can only get this with a prescription): https://www.medicines.org.uk/emc/product/2694/smpc#gref
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