Retained foreign objects in casts in children.

Abstract

Cast immobilization is a noninvasive and effective option in the treatment of fractures in children. However, its use can be associated with complications, such as pressure sores, skin infections, thermal injuries, and joint stiffness. In clinical practice, retained foreign objects in casts are not uncommon. This study aims to ascertain reasons for foreign objects being retained in casts and their effects on the skin. Eighteen children with retained foreign objects in their casts were identified and interviewed. Patient demographics, type of fracture and cast applied, nature of foreign body, and medical complications caused directly by the foreign object were also recorded for analysis. The foreign objects retained included coins, stationery, toy parts, cutlery, and hygiene items. The most common reason for their retention was to relieve itch, followed by accidental insertion and deliberate play. More than half of the children did not suffer complications, and the rest were all skin complications, with the most severe one being an infected skin ulcer that required oral antibiotics. Although the complications of retained foreign bodies are limited to the skin, they can worsen with delayed treatment. Cast care and itch reduction advice must be clearly communicated to patients and their caregivers. Foreign objects in casts must be emergently removed. Level of Evidence: Level 4 Evidence.