Hey moms, so yesterday my 3 yr old fell off a small table and landed on his elbow. Today the x rays showed a crack in his upper arm, just above the elbow and that his elbow is dislocated. The orthopedist said that we can cast it and it will most likely go back in place and heal great bc he is under 5, but the only way to ensure it does is to have pins put in the elbow, requiring anethstesia etc. the second option will be expensive, like possibly around 9,000 after we meet or deductible and pay our portion. The first option of just casting will be more like $500. But what if it doesn't heal right?? The doc said that either decision is perfectly fine and he will gladly do either but that if we want to go ahead with surgery, that we have to do it quick, because once it does heal we can't go back and do it then. So anyone have any experience or advice. I would love to hear from someone who has been through this.
Just FYI, it is apparently a decision on whether or not to do surgery in children under 5 due to their super human healing power as there is much more blood flow to their joints etc. if he was older, surgery would be un-avoidable. This is why I was hoping someone who had been through it is out there, but it's rare! The reason it's expensive is bc we changed our insurance to a high deductible plan, and we haven't come anywhere close to it yet as we just did this in January. We have a health savings account that rolls from year to year, but again just started in January.
****we went with casting after a second X-ray, doc felt very confident it will heal fine. We go in one week for a follow up X-ray, and cast comes off two weeks after that. Thanks mamas :)
No clue.
But these seems like too far flung of a medical choice to me.
It sounds like " you can buy a 1972 Gremlin for fifty bucks or a 2013 BMW for $40,000"!
I'd get a second opinion absolutely!
Good luck!
Get a second opinion TODAY, not bc this DR is bad or wrong, but bc you need more than one opinion to make this decision.
I assume... they also assessed how or if his growth plates would be affected or not by this injury????
In children, they have growth plates. And this also has to be considered per any injuries, and if it is affected or damaged or not.
Growth plates are not solid bone, and are soft tissue/bone and do not necessarily show up on x-rays.
I would get a 2nd opinion.
Can you get a second opinion? I would, because what happens if you cast and it doesn't heal correctly? Would they have to re break it and then do surgery?
Get a second opinion...
I would get a second opinion. The cost would be a non issue to me...this is your son's health. Additionally, I really would not want my child to have surgery if not absolutely necessary. That is a tough one. Did you ask the surgeon what he would do if your son was his child?
Get a second opinion from a pediatric orthopedist. Check the local children's hospital, or the hopspital you went to and find a pediatric orthopedist. Call and beg the receptionist, (tears work), bring the xray with you (pick it up from the hospital - it may cost $10-$15).
Call your insurance company and ask if they have a ped orthopedist in the network. Make sure they are board certified in ped ortho.
My cousin is an orthopedist surgeon and he has brought his own kids to pediatric orthopedists becuase it's just different when you're dealing iwth their soft bones, activitiy, etc. As it regards the cost - excellenet medical care is expensive. But wouldn't you do anything for your child? Is it a better investement than a car?
A good ped orthopedist will make a recommendation to you - and if he says it's really a 50/50 decision then ask what he'd do for his own child, brother, etc.
Good luck mama. God gives us this special intuition regarding our kids. If all else fails go with that.
Our son fractured his left arm when he was 5. We had it casted and relocated. He didn't need surgery. To this day, I ask him if his arm hurts, and he replies no. He turned 10 in Jan. Hope this helps with your decision. I know, it's a tough one to make.
My 4yo fractured her elbow in Nov. and we had the same options. I decided on casting because children are super healers. If the Dr. had said "you have no other choice but surgery", then it would have been surgery. But... if the choice is there for just casting, go for it. My kid wore her cast for a total of 2 weeks and healed perfectly on her own.
I would go for a second opinion. The two options sound drastically different. Since he was okay either way.. hmm. it sounds like he want you to do the surgery, but he would be okay with just casting?
I would question it.
My personal opinion is to avoid the surgery if possible. My concern is disruption in the growth plates of the elbow and hardware can create problems down the road with risk of infection and eventually might need to be removed. A 3 year old has very soft bones and are more "bendable" than breaking in two, sometimes called "greenstick" fractures which can heal nicely with casting.
Any time one undergoes surgery, there are anesthesia risks and invasive procedures put one at risk for getting infection.
Maybe another medical opinion would be beneficial in making the decision, like a pediatrician.
Given the option, I would take the more conservative route.
ALL medical decisions are made by the patient (or the parents of a minor) Now you may decide to do exactly what the doctor reccomends without questions -- but that is STILL YOUR DECISION!
Consider the risks and benefits, then ask a couple more questions...
The benefits of casting are that it's less invasive, probably less painful, and less expensive. The risk is that it might not heal as well.
The main beneift of surgery is that the healing will probably be better. But ALL surgery has risks-- adverse reactions to the anesthesia and infection at the top of the list, not to mention post-surgical PAIN
I'd probably go with casting, but I's want at least one question answered first "If we do the casting and it doesn't heal well, can we try the surgery later?"
I think I would get a second opinion.
However, I broke my arm above the elbow...actually, closer to the shoulder...when I was seven. My options were to have it in a crazy, crazy cast that would hold my shoulder out to the side...or wear it in a sling. My parents chose the sling...didn't even have a cast. Healed fine, I'm 32, and I've never had problems with it...and it was a full break, not just a fracture/crack.
Bones are amazing things. They WANT to heal correctly, and will generally do so...especially in young children. If it's not a full break, and he says a cast will be okay...I think I would go for a cast.
Also, I've never heard of a dislocation needing pins...and you're talking about putting pins in the elbow for a break that's above the elbow and a dislocated elbow.
Yup, time for a second opinion, if at all possible.
I agree - get the second opinion ASAP preferably at a children's hospital. There is a good one in Austin, right?
You may be able to set the bone and take weekly x-rays to see if it is healing right. If it's not, then surgery will be required.
Orthopedic Surgeons have one of the highest malpractice insurance rates due to lots of errors and lots of mis-set bones. Best to get that second opinion.
If the pins provide a greater assurance of proper and complete healing, go for the pins. Yes, cost should be a concern. To me, though, the greater concern is that for (God willing) better than 75 YEARS your son will live with the consequences of your choice. A fully healed, fully functioning arm is worth the money, in my book.
My son cracked his elbow once... healed just fine.
I am all for a conservative approach. If it doesn't heal properly, then you can always have the surgery done.
What I don't understand is that he is the doctor and he is leaving such a HUGE decision up to a parent with (I am assuming) no medical education. Why?
Further, why is it so costly after the insurance pays. None of this makes sense (to me).
In my experience, my daughter cracked her elbow when she was 7 and they gave her a cast, without giving me an option. Six weeks later, they removed the cast and she went on with her life.
Are the pins for the dislocated knee? I don't think he will need pins for a crack in his elbow.
Take him to see an ortho tomorrow.
