A fracture clinic: casts and their dates, post-op braces worn as prescribed, clubfoot casting, pin sites on a frame, and scoliosis bracing.
Every fracture treated in a cast, slab, splint or brace is on one clinic list from the day it goes on. The doctor sets the dates: when they want the check X-ray and when the cast is due off; the list shows what is due today and what is overdue. A cast is recorded as on only after the patient (or the person with them) has been given the clinic’s warning-signs advice — what to come back for at once, such as pain getting worse, numb or pale fingers, or a cast that is too tight — and the words given are kept on that cast. The doctor records what the check X-ray showed in their own words and the next check they want. A problem with the cast (a pressure sore, swelling, warning signs, a loose or broken cast) is recorded with what was done; a cast taken off for it is recorded as off in the same step. One cast is on at a time: a change is a removal and a new application. A fracture closes with the doctor’s outcome once nothing is on and every problem is settled. Post-op braces: a brace or splint after surgery is prescribed with the surgeon’s own wear schedule — their words, and hours a day when they give one — until a date, and every check of how it is actually worn, at a visit or by phone between visits, records what the patient or family reports, any fit or skin problem and what was done. A patient not wearing it as prescribed, or a check the surgeon wanted that is overdue, leads the list before the next visit. Clubfoot casting follows a child treated by the Ponseti method: casts recorded once applied, numbered per foot, with the Pirani score and abduction as measured on the surgeon’s own interval, the tenotomy, then bracing only on the surgeon’s prescription with the hours reported at each check. Pin sites keep every external fixator and ring frame with its pins and wires by label: each check, on the surgeon’s interval, covers every pin still in, a purulent or loose pin needs what was done and which doctor was told, and a pin red or wet on two checks running is flagged. Scoliosis bracing keeps brace wear against the hours the surgeon prescribed and each curve’s Cobb angle from the radiologist’s report; progression is flagged only at the surgeon’s own number. Nothing here sets a schedule.
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