Upper Limb - MiscellaneousRetained foreign objects in casts in childrenHui Min Cheng, Gloriaa,,b; Jia-Yi Shi, Clarisa,,b; Jia Ying Lee, Beatricea; Lim, Kevin Boon LeongaAuthor Information aDepartment of Orthopedic Surgery, KK Women’s and Children’s Hospital bDepartment of Orthopedic Surgery, Tan Tock Seng Hospital, Singapore Correspondence to Kevin Boon Leong Lim, FRCS (Eng), FRCSEd (Orth), MBA, Department of Orthopedic Surgery, KK Women’s and Children’s Hospital, 100 Bukit Timah Road, 229899, Singapore Tel: + 65 6394 8988; fax: + 65 6291 9232; e-mail: firstname.lastname@example.org Journal of Pediatric Orthopaedics B: March 2020 - Volume 29 - Issue 2 - p 200-202 doi: 10.1097/BPB.0000000000000609 Buy Metrics Abstract Cast immobilization is a noninvasive and effective option in the treatment of fractures in children. However, its use can be associated with complications, such as pressure sores, skin infections, thermal injuries, and joint stiffness. In clinical practice, retained foreign objects in casts are not uncommon. This study aims to ascertain reasons for foreign objects being retained in casts and their effects on the skin. Eighteen children with retained foreign objects in their casts were identified and interviewed. Patient demographics, type of fracture and cast applied, nature of foreign body, and medical complications caused directly by the foreign object were also recorded for analysis. The foreign objects retained included coins, stationery, toy parts, cutlery, and hygiene items. The most common reason for their retention was to relieve itch, followed by accidental insertion and deliberate play. More than half of the children did not suffer complications, and the rest were all skin complications, with the most severe one being an infected skin ulcer that required oral antibiotics. Although the complications of retained foreign bodies are limited to the skin, they can worsen with delayed treatment. Cast care and itch reduction advice must be clearly communicated to patients and their caregivers. Foreign objects in casts must be emergently removed. Level of Evidence: Level 4 Evidence. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.