fracture clinic
atients with fractures may be seen by Dr. Klippenstein through the Fracture Clinic, usually on referral from other physicians or the Emergency Department. The Fracture Clinic is located in the Ambulatory Care Clinics area on the main floor at the front of BRHC. Patients may be seen here for initial consultation, and followed up for management of their fractures, cast changes, and sometimes prescription of braces and orthotics. Physiotherapy may be arranged at these follow ups. Our team includes Orthopaedic Technicians Igor Fluerar and Cynthia Brown, who help set fractures, apply and remove casts, fit various orthopaedic appliances, and manage surgical wounds.
Appointments are made through the Fracture Clinic reception clerk, and patients will be notified of appointment times. If any changes need to be made, the Fracture Clinic should be notified as soon as possible (204-578-4200).
It is always helpful if family members or friends can be in attendance for these appointments, and patients can be dropped off at the circular front entrance on the north side of the hospital, where a wheelchair can be made available if necessary. Xrays are usually arranged during Fracture Clinic visits, and are performed at the BRHC X-ray department down the hall. It is important that patients attend appointments as arranged, as healing fractures, especially in the first few weeks, can occasionally change position even in a cast, and this needs to be identified promptly to make necessary corrections.
Appropriate fracture management includes proper care of casts, and cast instructions should be followed carefully. In the first few days after cast application, especially if a closed reduction or fracture setting has been performed, swelling in the cast can be a problem. This can lead to increased pain, decreased circulation, and potential nerve injury if not addressed promptly. The first response to excessive swelling should be elevation of the affected limb, to above the level of the heart, until painful throbbing improves. The fingers or toes can be gently flexed to assist. This may need to be done for an extended period of time or repeated regularly for swelling and pain to improve. If it does not, it may be necessary to attend the hospital for consideration of splitting of the cast to alleviate pressure.
A cast needs to be kept as dry as possible, and if it does get wet, it may be possible to dry it with a hair dryer. To shower, a plastic bag may be placed over the cast with an elastic to seal it above the cast. Plaster casts are more susceptible to water damage than fibreglass casts, but in either case the cotton lining can be compromised if wet and this should be avoided. Waterproof casts can sometimes be used, at an additional cost. Sharp objects should never be inserted inside the casts, as skin injury may result. Patients should never ever try to remove a cast on their own, as this can cause significant injury. If a cast needs to be removed or trimmed, this should always be done by trained personnel.