Internal Reference Number: FOI_9335
Date Request Received: 09/04/2026 00:00:00
Date Request Replied To: 21/05/2026 00:00:00
This response was sent via: By Email
Request Summary: ED - paediatric patients - Fractures
Request Category: Health
| Question Number 1: Could you confirm the name of each hospital with an emergency department within your trust. For each hospital in your trust with an emergency department could you please answer the following: Section 1: Department details 1. Type of department • Paediatric ED • Mixed ED with paediatric area • General ED seeing children • Minor injury unit or urgent treatment centre • Other | |
| Answer To Question 1: The Trust has a mixed ED with Paediatric area. | |
| Question Number 2: 2. Does your department have a written local guideline for paediatric upper limb fractures? • Yes • No • Unsure | |
| Answer To Question 2: Yes | |
| Question Number 3: If Yes - would you be able to share it please with us? 3. Which guidance most strongly informs local practice for your paediatric patients? • NICE (National institute of Clinical Excellence) • BOAST ( British Orthopaedic Association) • BSCOS ( British society of Children’s orthopaedics) template or local adaptation • Local orthopaedic guideline • Local Emergency Department guideline • Other | |
| Answer To Question 3: Local orthopaedic guideline - ENPs have it as a print out. | |
| Question Number 4: 4. Is a virtual fracture clinic available for paediatric fractures? • Yes • No • Only for selected fracture types - could you specified which ones please? | |
| Answer To Question 4: Yes we have a VFC for paediatric fractures. | |
| Question Number 5: 5. Are written discharge leaflets routinely given for paediatric fractures? • Always • Usually • Sometimes • Never | |
| Answer To Question 5: The Trust always give out leaflets for fractures. | |
| Question Number 6: For each of the following fractures for each of your departments could you answer the questions for your paediatric patients? Clavicular fracture (uncomplicated closed midshaft clavicle fracture) 1. Usual immobilisation • No immobilisation • Broad arm sling • Collar and cuff • Figure-of-8 brace • Other 2. Usual follow-up • No routine follow-up • Virtual fracture clinic • Face-to-face fracture clinic • Orthopaedic clinic only if adolescent or displaced • Other 3. Is orthopaedic discussion routinely required from ED? • No • Only if significantly displaced, skin compromise, open fracture, or neurovascular concern • Yes for most clavicle fractures • Other | |
| Answer To Question 6: Clavicle fractures: 1. Broad arm sling 2. No follow up/VFC depending on the fracture 3. no Ortho discussion | |
| Question Number 7: Closed Supracondylar humerus fracture 1. Gartland I or radiologically occult but clinically suspicious supracondylar injury: usual immobilisation • Collar and cuff • Posterior backslab • Above-elbow cast • Other 2. Gartland I: usual follow-up • No routine follow-up • Virtual fracture clinic • Face-to-face fracture clinic • Other 3. Gartland II or III: usual first ED step • Backslab and refer orthopaedics • Immediate orthopaedic review in ED • Admit under orthopaedics • Transfer to another centre • Other 4. For Gartland II or III injuries, is reduction or manipulation attempted in ED before theatre or admission? • Never • Occasionally in selected cases • Usually • Unsure 5. Is neurovascular status formally documented before and after immobilisation or reduction? • Always • Usually • Sometimes • Never | |
| Answer To Question 7: Close supra-condylar fractures: 1. Above elbow cast 2. VFC 3. Backslab and ref ortho 4. Occasionally in selected cases 5. Always | |
| Question Number 8: Lateral closed condyle fracture 1. Undisplaced lateral condyle fracture: usual ED immobilisation • Backslab • Above-elbow cast • Sling only • Other 2. Undisplaced lateral condyle fracture: usual follow-up • Face-to-face fracture clinic within 1 week • Virtual fracture clinic • No routine follow-up • Other 3. Displaced or uncertain lateral condyle fracture: usual ED pathway • Backslab and orthopaedic discussion • Immediate orthopaedic review • Admit or transfer • Other | |
| Answer To Question 8: Lateral closed condyle fracture: 1. Above elbow backslab 2. VFC 3. Backslab and ortho discussion | |
| Question Number 9: Radial neck or radial head fracture 1. Undisplaced or minimally angulated fracture: usual immobilisation • Collar and cuff • Broad arm sling • Backslab • Other 2. Undisplaced or minimally angulated fracture: usual follow-up • No routine follow-up • Virtual fracture clinic • Face-to-face fracture clinic • Other 3. For more displaced or intra-articular injuries, what is the usual ED pathway? • Orthopaedic discussion then discharge in immobilisation • Admit under orthopaedics • Transfer to another centre • Other | |
| Answer To Question 9: Radial neck/head fracture: 1. Collar and Cuff 2. VFC 3. Admit under ortho | |
| Question Number 10: Buckle fractures 1. Usual immobilisation • No immobilisation • Soft bandage • Removable wrist splint • Soft cast or backslab • Circumferential cast • Other 2. Is the child usually discharged from ED with no planned follow-up? • Yes • No • Depends on clinician • Unsure 3. If follow-up is arranged, what is usual? • No follow-up • Virtual fracture clinic • Face-to-face fracture clinic • GP follow-up • Other 4. Are parents or carers advised to remove immobilisation at home? • Yes • No • Depends on device used 5. Is a written buckle fracture advice leaflet routinely given? • Always • Usually • Sometimes • Never | |
| Answer To Question 10: Buckle fractures: 1. Removable wrist splint 2. No follow up 3. No follow up 4. Yes 5. Always given a leaflet | |
| Question Number 11: Distal radius greenstick or undisplaced metaphyseal fracture 1. Usual immobilisation • Removable wrist splint • Below-elbow backslab or soft cast • Below-elbow full cast • Above-elbow cast • Other 2. Usual follow-up • No routine follow-up • Virtual fracture clinic • Face-to-face fracture clinic • Other 3. Is home removal of immobilisation routinely advised? • Yes • No • Depends on fracture pattern | |
| Answer To Question 11: Distal greenstick fractures: 1. Removable wrist splint. 2. No follow up. 3. Yes | |
| Question Number 12: Distal radius closed displaced fracture or distal radial physeal injury 1. If reduction is required, is this usually attempted in ED? • Yes, usually • Yes, in selected cases only • No, usually managed by orthopaedics after admission • Unsure 2. Post-reduction immobilisation • Below-elbow backslab • Below-elbow full cast • Above-elbow backslab • Above-elbow full cast • Other 3. Usual follow-up • Virtual fracture clinic • Face-to-face fracture clinic within 1 week • Admit under orthopaedics • Other | |
| Answer To Question 12: Distal radius closed fracture: 1. Yes depending on how busy the ED is. 2. Below elbow backslab. 3. VFC. | |
| To return to the list of all the FOI requests please click here |
Our staff at SA¹ú¼Ê´«Ã½ Hospital have long been well regarded for the quality of care and treatment they provide for our patients and for their innovation, commitment and professionalism. This has been recognised in a wide range of achievements and it is reflected in our award of NHS Foundation Trust status. This is afforded to hospitals that provide the highest standards of care.
