Being injured is never a pleasant experience, which is why Mike does his best to provide a caring and professional environment in which to treat his patients.


PLASTER CASTS

The practice has a fully equipped procedure room in which we apply and remove plaster casts. Mindful that this process can be a little frightening for the patient - adult or child - we take care to carry out our work in a calm, reassuring and professional manner.

Our goal is to make recovery as comfortable as possible, which is why we stock modern casting materials (in a limited range of colours) and if the injury allows, we fit a cast that can get wet. This frees the patient to bath and swim.

We also teach patients how to care for their cast - an important part of preventing unnecessary complications.


CHILD: CAST REMOVAL

Dr Mulder uses an electric plaster saw to remove the cast. And while the saw is noisy and may be a little scary, it doesn’t hurt. Please calmly prepare your child for the removal process. If your child is small, or you are concerned that he or she may be frightened by the experience, you can administer a painkiller such as Stopayne to help calm the nerves.

After removal of the cast one can expect the limb to feel weak, awkward and generally very strange. Children are often disappointed by the fact that the arm is not perfect immediately on removal of the cast. Mike will discuss specific precautions with you when the cast is removed.


CHILD: POST CAST REMOVAL CARE

The cast is removed once initial healing has occurred and the bone no longer requires support. However it’s important to know that the bone will not be sufficiently strong enough to withstand all activities. Ironically in the 4-6 weeks after the cast is removed, the arm is more vulnerable to injury than at the time it was in the cast, so playing it safe is crucial.

Avoid the following activities in the first 6 weeks post removal:

  • Contact sports (rugby, martial arts, skateboarding).
  • Jungle gyms, jumping castles, trampolines, monkey bars, J-boards, skateboards, rollerblades, roller skates, heelies, “play fighting”/wrestling.

While we understand that it’s impossible to shield your child from all potential risks, please be aware that this is a delicate time and try to take as much care as you can.

Return to non-contact sports (hockey, netball, cricket, tennis, etc.) is specific to the injury your child has sustained and Dr Mulder will discuss this with you in person.

Swimming is an excellent and safe form of exercise in this initial period. And physiotherapy is rarely used following forearm fractures in children.


REMOVAL OF PINS

Smooth pins are often used in the treatment of fractures in children and hand fractures (both adults and children). The pins may be left protruding through the skin or lie buried beneath it. The length of time they stay in place for depends on the location and severity of the injury.

Where the pins are buried beneath the skin an anesthetic is needed to take them out. Likewise, in cases where we assess that it will be too stressful for the child, we will arrange for a form of anaesthetic to help keep them calm.

If the pins are exposed however, we take them out in our rooms. This may sound a little scary, but we promise, it’s a lot less painful than one imagines it to be. We do however recommend that you give your child some Stopayne or other painkiller to help steady their nerves beforehand.

In our experience a calm approach with children in our rooms is far less traumatic than a trip to the operating theatre to remove the pins. And besides, we have a collection of lollipops that rivals a sweet shop - the best recovery medicine of all.


DRESSING CLINIC

Our practice is equipped to provide comprehensive care for wounds; these include surgical wounds and the care of those acquired through injury. Dr Mulder and Sr Seona are experienced in the management of hand and finger injuries, and offer all patients specialised treatment.


DIAGNOSTIC ULTRASOUND

Depending on the nature of the injury Mike may need to make use of portable ultrasound to assist in the immediate detection of muscle and tendon injuries, and accurate diagnostic injections. The procedure is quick and completely painless.




ON CALL SERVICE / EMERGENCIES

Dr Mulder is committed to dealing  with issues which arise following surgery. If you are experiencing problems following surgery, please contact the office, if Sister Seona cannot help you, she will put you in touch with Dr Mulder. If problems arise after hours or weekends, please contact Dr Mulder via his cell phone. Please be aware that he may not always be available and if you feel the problem requires immediate attention, please proceed straight to the Emergency Unit at Constantiaberg. The hospital always has an Orthopaedic surgeon available to deal with emergencies.

On the days when Dr Mulder is on call, patients needing emergency care may be seen by him on admission, or may be given his business card to make an appointment to be seen at the next appropriate or available appointment. The timing of this appointment is dictated by the nature of the injury.

As Mike’s preference and expertise is in upper limb injuries, lower limb injuries may be referred and seen by his partner, Dr Roy Endenburg.


WORKMAN’S COMPENSATION INJURY

Our practice accepts and manages patients who have been injured at work and are insured through the COIDA. Please let us know if this is relevant to your circumstances when booking your appointment. We need to have the necessary documentation ready for you - as we can’t treat you without it.