24 Musculosketal problems
Before you go on a placement in children’s orthopaedics, it will be helpful for you to think about the following possible learning opportunities:
- Assisting the child return to their best function and mobility after an MSK injury or orthopaedic intervention requires intervention from different key members of the MDT team. Consider the roles of the physiotherapist and occupational therapist in relation to a child you may be caring for on the ward. Spend some time with these health professionals and reflect on how their interventions have supported the child in their return to optimum health.
- Children often require plaster cast immobilisation. If possible accompany a child to plaster room (e.g. for new cast application or cast removal), to better understand how this may affect them. The plaster saw is noisy and vibrates. How might you prepare a child who needs a cast removed? Discuss this with the play specialist.
- Genetics – many orthopaedic conditions are linked to a syndrome. Read up on genetics (starting with Chapter 10 in Essentials of Nursing Children and Young People).
- Antenatal screening – conditions such as clubfoot can be detected on the 20-week scan, so try to get some placement time in screening.
- Parent education – healthy diet and lifestyle advice to promote optimum bone health is essential. Try to get some experience of parent education in this area whilst on relevant placements.
- Safeguarding - take a look at the leaflet ‘CORE-INFO: Fractures in children’ produced by the NSPCC and Cardiff Child Protection Systematic Reviews: www.nspcc.org.uk/globalassets/documents/advice-and-info/core-info-fractures-children.pdf
Consider the relationship between children’s fractures and non-accidental injury. Think about what support is available in your placement workplace for the health professional and the child and family, when a possible non-accidental injury is being investigated.