Fiberglass and plaster casts are widely used to treat broken bones in kids, but they have drawbacks compared with other methods such as braces and splints, experts say.

Doctors and patients should review the available options, considering not only treatment of the fracture, but also patient comfort and compliance as well as the burden on the family, according to a review article in the January issue of the Journal of the American Academy of Orthopaedic Surgeons.

Children "may be eager to get a cast, choosing a colour that fits their personality," said lead author Dr. Eric Shirley, a pediatric orthopedic surgeon at Naval Medical Center Portsmouth in Virginia.

"However, the thrill soon wears off when they learn that they will be unable to play, swim or engage in high-impact activities while wearing a cast. What's more, complications like itching, blisters or dermatitis associated with cast management can lead to added frustration," he said in a journal news release.

A cast can also be a challenge for children attending school, and families have to schedule follow-up visits for cast removal. For every 100 pediatric fracture clinic appointments, 54 school days and 25 workdays are missed.

And complications with casts can require emergency department visits that put time and cost burdens on both the family and the health care system.

"Pediatric patients are often seen in the emergency department with issues related to wet or damaged casts," Shirley said. "These complications can nearly always be addressed during normal clinic hours; however, we find that families do not want to wait or feel anxious when caring for a cast."

Using alternatives such as braces, soft casts or splints could help reduce patient anxiety, eliminate cast complications, and reduce follow-up visits, care costs and time missed from school and work, according to the review. These alternatives are acceptable and effective for certain fractures to the forearm, shin, foot or ankle, but are not used not as often as they could be in children, the authors said.

Parents should talk with their orthopedic surgeon about the benefits and drawbacks of the different treatment options for children with broken bones, Shirley advised.

Air pollution not only raises the risk of lung cancer, stroke and respiratory diseases, but it is also bad for your bones, a new study suggests.

The study, done in India, looked at more than 3,700 people from 28 villages outside the city of Hyderabad.

The researchers estimated exposure of fine particulate air pollution and asked participants what fuel they used for cooking. Fine particulate air pollution consists of tiny particles measuring 2.5 micrometers and also black carbon.

Particle levels in the area were far higher than the maximum recommended by the World Health Organisation, researchers said.

They then compared this information with bone density in participants' lumbar spine and left hip.

The conclusion: Exposure to high levels of fine particulate matter was linked to lower bone mass.

"This study contributes to the limited and inconclusive literature on air pollution and bone health," researcher Otavio Ranzani said in a news release.

He's a postdoctoral fellow at the Barcelona Institute for Global Health (ISGlobal) in Spain.  "Inhalation of polluting particles could lead to bone mass loss through the oxidative stress and inflammation caused by air pollution," Ranzani added.