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Abstract
Objective: To describe the nursing care activities for pediatric patients with limb fractures treated with cast immobilization at the Pediatric Orthopedic Department, National Children’s Hospital, in 2024.
Methods: A prospective descriptive study was conducted on 121 pediatric patients with limb fractures indicated for cast immobilization at the Pediatric Orthopedic Department, National Children’s Hospital, from February to August 2024. The instrument was developed based on Henderson’s 14 basic needs and Circular No. 31/2021/TT-BYT regulating nursing activities in hospitals. Its reliability was assessed, yielding a Cronbach’s alpha of 0.870. The instrument was also reviewed by a panel of eight experts, including pediatric physicians and pediatric nurses. The instrument demonstrated good reliability with a Cronbach’s alpha coefficient of 0.870.
Results: The mean age of the participants was 5.35 ± 2.21 years, with children under 6 years accounting for 56.2% of the sample. Females comprised 52.1% of participants, 95.9% were of Kinh ethnicity, and 87.6% had health insurance. The leading cause of fractures was domestic accidents (94.2%). Before cast application, 59.5% of patients experienced severe pain and 43.8% had swelling of the injured limb. Twenty-four hours after cast application, these conditions improved markedly, with only 9.1% still reporting severe pain and 33.9% having persistent swelling. At the time of cast removal, 75.2% of children were pain-free. In addition, 100% of patients received monitoring of vital signs and distal limb circulation during the first 24 hours after cast application. Overall, good nursing care activities were achieved in 82.6% of patients. However, the rates of muscle atrophy and joint stiffness following cast immobilization remained relatively high, at 26.4% and 19.8%, respectively.
Conclusion: During the nursing care process, greater emphasis should be placed on educating pediatric patients and their families about performing isometric muscle contraction exercises while in the cast and initiating rehabilitation exercises immediately after cast removal to prevent muscle atrophy and joint stiffness.
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References
Hung Quoc Truong, Quang Dinh Nam Vo. Percutaneous Lateral Cross-Wiring Of Supracondylar Fractures Of The Humerus In Children At Hospital For Traumatology And Orthopedics. Cantho Journal of Medicine and Pharmacy. 2023; (68): 139-145. DOI: 10.58490/ctump.2023i68.2259
Peterson K, Laboy C. Pediatric fractures: A nursing perspective. Nursing2026. 2026; 56(1): 15-22. doi: 10.1097/NSG.0000000000000315.
Gu W, Guo H, Wang X, Sun Y, Ni L. Epidemiological features and injury patterns of multiple fractures in children: a cross-sectional study. Frontiers in Public Health. 2025; Volume 13 - 2025. doi: 10.3389/fpubh.2025.1709382.
Võ Ngọc Long, Lê Ngọc Quyên, Nguyễn Thị Kim Bằng và cộng sự. Kết quả chăm sóc điều dưỡng sau phẫu thuật kết hợp xương chi trên và các yếu tố liên quan tại Bệnh viện Chấn thương chỉnh hình Thành phố Hồ Chí Minh. Tạp chí Y học Việt Nam. 2026; 561(1): 260-264. DOI: 10.51298/vmj.v561i1.18177.
Liu H, Wang Y, Li M, Chen D, Tang Y. Compliance of functional exercises in school-age children with limb fractures: implication for nursing countermeasures. BMC Pediatrics. 2022; 22(1): 133. doi: 10.1186/s12887-022-03193-6.
Mitchell BC, Baldwin K. Properties and Pitfalls of Various Casting Materials. Journal of the Pediatric Orthopaedic Society of North America. 2025; 12: 100234. doi: 10.1016/j.jposna.2025.100234.
Nguyễn Thị Thắm, Nguyễn Bảo Lục và Võ Thành Toàn. Kết quả điều trị gãy kín đầu dưới xương quay bằng nắn bó bột tại Bệnh viện Thống Nhất. Tạp chí Y học Việt Nam. 2021; 498(2): 58-62. DOI: 10.51298/vmj.v498i2.172
Polit DF, Beck CT. The content validity index: are you sure you know what’s being reported? Critique and recommendations. Research in nursing & health. 2006; 29(5): 489-497. doi: 10.1002/nur.20147.
Dương Đình Toàn, Võ Quốc Hưng, Nguyễn Trọng Tài. Đánh giá kết quả điều trị bảo tồn gãy kín thân xương đùi trẻ em tại Bệnh viện Hữu nghị Việt Đức. Tạp chí Y học Việt nam. Tập 508 Số 2 (2021). DOI: 10.51298/vmj.v508i2.1652
Hardy EJ, Inns TB, Hatt J, et al. The time course of disuse muscle atrophy of the lower limb in health and disease. Journal of Cachexia, Sarcopenia and Muscle. 2022; 13(6): 2616-2629. doi: 10.1002/jcsm.13067.
Gao Y, Arfat Y, Wang H, Goswami N. Muscle atrophy induced by mechanical unloading: mechanisms and potential countermeasures. Frontiers in physiology. 2018; 9: 235. doi: 10.3389/fphys.2018.00235.
Wang F, Zhang Q-B, Zhou Y, et al. The mechanisms and treatments of muscular pathological changes in immobilization-induced joint contracture: A literature review. Chinese Journal of Traumatology. 2019; 22(02): 93-98. doi: 10.1016/j.cjtee.2019.02.001.
Zhang Q, Jin F, Weng J, et al. Clinical impact of child life intervention combined with comprehensive nutrition intervention on pain management, nutritional status, and treatment compliance in school-age children with limb fractures. Frontiers in Medicine. 2025; 12: 1658982.https://doi.org/10.3389/fmed.2025.1658982
Gupta K, Erdman MK, Siddiqui A, Schur M, Meisel E, Goldstein RY. Age is a predictor of elbow stiffness after type III or IV supracondylar humerus fractures. Eur J Orthop Surg Traumatol. 2024; 34(6): 3067-3071. doi: 10.1007/s00590-024-04031-4.
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