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Open Reduction With Internal Fixation of a Limb in Children: What to Expect at Home

Your Child's Recovery

Your child can expect some pain and swelling around the cut (incision) the doctor made. This should get better within a few days. But it's normal for your child to have some pain for 2 to 3 weeks after surgery. Mild pain may last up to 6 weeks.

The doctor may give you specific instructions on when your child can do normal activities again, such as sports and going back to school or work.

This care sheet gives you a general idea about how long it will take for your child to recover. But each child recovers at a different pace. Follow the steps below to help your child get better as quickly as possible.

How can you care for your child at home?

Activity

Have your child rest when feeling tired.
Increase your child's activity as recommended by your doctor. Being active boosts blood flow and helps prevent pneumonia and constipation. It's usually okay for your child to exercise other parts of the body as soon as your child feels well enough.
Help your child keep all weight off of the repaired bone until your doctor says it is okay.
Your child will probably need to take 1 to 2 weeks off from school or work.
Your child may shower 24 to 48 hours after surgery. When your child showers, be sure to keep the dressing and incisions dry. If your child has a cast, tape a sheet of plastic to cover it so that it doesn't get wet. It may help if your child sits on a shower stool.
Your child should not take a bath, swim, use a hot tub, or soak the affected limb until the incision is healed. Wait at least 3 weeks or until seen by your doctor.

Diet

Your child can eat a normal diet. If your child's stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.

Medicines

Your doctor will tell you if and when your child can restart any medicines. The doctor will also give you instructions about any new medicines.
If your child takes aspirin or some other blood thinner, be sure to talk to your doctor. The doctor will tell you if and when your child can start taking this medicine again. Make sure that you understand exactly what your doctor wants you to do.
If the doctor gave your child a prescription medicine for pain, give it as prescribed.
If your child is not taking a prescription pain medicine, ask the doctor if your child can take an over-the-counter medicine.
If your doctor prescribed antibiotics, give them to your child as directed. Do not stop giving them just because your child feels better. Your child needs to take the full course of antibiotics.

Incision care

If your child has strips of tape on the cut (incision) the doctor made, leave the tape on for a week or until it falls off.
If your child doesn't have a cast, clean the incision 2 times a day after your doctor allows your child to remove the bandage. Use only soap and water to clean the incision unless your doctor gives you different instructions. Don't use hydrogen peroxide or alcohol. They can slow healing.

Exercise

Help your child follow instructions from your doctor or physiotherapist about what exercises to do. These exercises will help keep your child's muscles strong and the joints flexible while the bone is healing.
Have your child wiggle their fingers or toes on the injured arm or leg often. This helps reduce swelling and stiffness.

Ice and elevation

Prop up the injured arm or leg on a pillow when your child ices it or anytime your child sits or lies down during the first 1 to 2 weeks after surgery. Try to keep it above the level of the heart. This will help reduce swelling and pain.

Other instructions

If your child has a cast or splint:
- Keep it dry.
- If your child has a removable splint, ask your doctor if it's okay to take it off to bathe. Your doctor may want your child to keep it on as much as possible. Be careful not to put the splint on too tight.
- Don't let your child stick objects such as pencils or coat hangers in the cast or splint to scratch the skin.
- Don't let your child put powder into the cast or splint to relieve itchy skin.
- Never cut or alter your child's cast or splint.

Follow-up care is a key part of your child's treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if your child is having problems. It's also a good idea to know your child's test results and keep a list of the medicines your child takes.

When should you call for help?

Call 911 anytime you think your child may need emergency care. For example, call if:

Your child passes out (loses consciousness).
Your child has severe trouble breathing.
Your child has sudden chest pain, is short of breath, or coughs up blood.

Call your doctor or nurse advice line now or seek immediate medical care if:

Your child has pain that does not get better after taking pain medicine.
Your child's fingers or toes on the injured arm or leg are cool or pale or change colour.
Your child's fingers or toes are tingly, weak, or numb.
Your child can't move their fingers or toes.
Your child's cast or splint feels too tight.
The skin under your child's cast or splint is burning or stinging.
Your child has symptoms of infection, such as:
- Increased pain, swelling, warmth, or redness.
- Red streaks leading from the incision.
- Pus draining from the incision.
- A fever.
Your child has drainage or a bad smell coming from the cast or splint.
Your child has signs of a blood clot in the leg (called a deep vein thrombosis), such as:
- Pain in the calf, back of the knee, thigh, or groin.
- Swelling in the leg or groin.
- A colour change on the leg or groin. The skin may be reddish or purplish, depending on your child's usual skin colour.

Watch closely for any changes in your child's health, and be sure to contact your doctor or nurse advice line if:

Your child has a problem with the splint or cast.

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