Colles Wrist Fracture, Reduction (Child)

Home care

Follow these guidelines when caring for your child at home:

• Give your child pain medicines as directed by the healthcare provider. Don't give your child aspirin unless told to by a healthcare provider.

• Follow the healthcare provider's directions about how much your child should use the affected arm.

• Keep your child's hand and wrist elevated to reduce pain and swelling.  For babies or toddlers, lay the child down and place pillows under the hand until the injury is raised above the level of the heart. Be sure that the pillows don't move near the face of the baby or toddler. Never leave the child unsupervised.

• Put a cold pack on the injury to help control swelling. You can make a cold pack by wrapping a plastic bag of ice cubes in a thin towel. As the ice melts, make sure that the cast doesn’t get wet. Don't place the ice directly on the skin, as this can cause damage. You can place a cold pack directly over the cast.

• Ice the injured area for up to 20 minutes every 1 to 2 hours the first day. Continue to do this 3 to 4 times a day for the next 2 days, then as needed. It may help to make a game of using the ice. But if your child objects, don't force your child to use the ice. 

• Care for the cast as you’ve been directed. Don’t put any powders or lotions inside the cast. Keep your child from sticking objects into the cast.

• Always keep the cast completely dry. Have your child bathe with their cast or splint out of the water. Protect it with 2 layers of plastic, such as 2 plastic bags. Close the top end of the bag with tape or rubber bands.

• Encourage your child to wiggle or exercise the fingers of the affected hand often.

Follow-up care

Follow up with the child's healthcare provider as advised. Your child may need follow-up X-rays to see how the bone is healing. If your child was referred to a specialist, make that appointment soon.

Special note to parents

Healthcare providers are trained to recognize injuries like this one in young children as a sign of possible abuse. Several healthcare providers may ask questions about how your child was injured. They are required by law, ask you these questions. This is done for the protection of the child. Please try to be patient and not take offense.

When to get medical care

Call your child's healthcare provider right away if any of the following occur:

• Wet or soft cast

• Cast is too tight or too loose

• Increasing swelling or pain after the cast is put on (babies may show pain with crying that can't be soothed)

• Fingers on the injured hand are cold, blue, numb, burning, or tingly 

• Child can’t move the fingers of the affected hand

• Redness, warmth, swelling, or fluid leaking from the wound, or bad smell from the cast

• In babies, fussiness or crying that cannot be soothed

• Fever (see Fever and children, below)

Call 911

Call 911 if your child has:

• Trouble breathing

• Confusion

• Trouble awakening or is very drowsy

• Fainting or loss of consciousness

• Rapid heart rate

• Seizure

• Stiff neck

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

• Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use a rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below is when to call the healthcare provider if your child has a fever. Your child’s healthcare provider may give you different numbers. Follow their instructions.

When to call a healthcare provider about your child’s fever

For a baby under 3 months old:

• First, ask your child’s healthcare provider how you should take the temperature.

• Rectal or forehead: 100.4°F (38°C) or higher

• Armpit: 99°F (37.2°C) or higher

• A fever of ___________as advised by the provider

For a child age 3 months to 36 months (3 years):

• Rectal or forehead: 102°F (38.9°C) or higher

• Ear (only for use over age 6 months): 102°F (38.9°C) or higher

• A fever of ___________ as advised by the provider

In these cases:

• Armpit temperature of 103°F (39.4°C) or higher in a child of any age

• Temperature of 104°F (40°C) or higher in a child of any age

• A fever of ___________ as advised by the provider