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If your child has had a neck injury – either a soft tissue injury (e.g. muscle, ligament, tendons) or a stable fracture of the cervical spine (neck) – they may need to wear a hard collar (a rigid neck collar) while they heal. A hard collar is also sometimes referred to as an Aspen collar or
Your doctor will determine how many weeks your child needs to wear the collar. This will depend on how quickly the injury heals, which will normally be checked with an X-ray or an assessment in hospital. In most cases, the collar will be worn full time for six to 12 weeks.
Hard collars are sometimes used for children who have been discharged from a hospital emergency department with ongoing neck pain, but their X-rays are normal and a bone injury is not likely. In these cases, your child may be given a referral to a fracture clinic for an appointment in around
two weeks. Until this follow-up appointment, your child should wear their collar as directed by their treating doctor.
Soft tissue injuries and fractures are painful. Although immobilising the neck with a collar will help to reduce the pain, additional pain relief (e.g. paracetamol) is often needed. Give pain relief medication regularly for the first few days, following the directions on the packet, or as
directed by the doctor.
Your doctor will let you know if your child needs to keep their collar on all the time or if it can be removed for short periods. Your child may need to wear the neck collar 24 hours a day without removing it at all, or the doctor may say that you can remove the collar to wash the neck while
the head is immobilised.
Some children with less severe injuries may only need to wear the hard collar for comfort, as it often provides pain relief following soft tissue injuries.
Unless your doctor has told you otherwise, your child will need to sleep in the collar. It is important that your child keeps their neck in a normal alignment while their injury heals, and this includes during sleep. When sleeping, your child should be encouraged to sleep on their back without
pillows, to keep the neck as straight as possible.
The collar will affect your child’s ability to move their neck and this can increase the risk of slips and falls while bathing. To help prevent falls from happening:
It is very important that you only remove the neck collar to wash your child’s neck if your doctor has allowed it.
When washing your child’s neck, it is best to have another adult helping, especially for younger or less cooperative children.
Take your child to your GP or local hospital if there is increasing pain, or any pins and needles or weakness/numbness in the arms or legs, following a neck injury.
If you are allowed to take the collar off for washing, take the opportunity to check the skin for any areas of pressure. If there are any areas of broken skin under the collar, have this reviewed by a doctor.
If you are concerned the collar is not fitting properly, or there any marks on the skin that may have been caused by pressure, make an appointment to see your orthotist or treating healthcare provider.
Your child may need to have an X-ray and review after their injury. The doctor will tell you when your child should have their follow-up appointment. Once the doctor has confirmed your child’s neck has healed, the collar can be removed.
If your child needed to wear their collar for 24 hours a day without removing it, after the collar is taken off the skin may be dry and itchy. Bathe the skin with warm water and soap, and apply a plain, non-perfumed moisturiser.
After their neck collar has been removed, your child’s neck may feel stiff and sore. This will improve with time and gentle stretching, if advised. Physiotherapy is usually not needed.
Your doctor will give you specific advice regarding when your child can return to sport.
Why was my child told to wear the collar when no fracture
was seen on x-ray?
Your child may have been told to wear the collar to provide
pain relief and as a precaution in case a small, subtle fracture occurred,
which cannot always be seen on an X-ray. Your child will be reviewed during a
follow-up clinic appointment, usually within two weeks.
We’ve had a hard collar for few weeks and it is looking
dirty and beginning to smell a bit. Can I clean it?
collar contains soft pads to protect the skin and minimise discomfort. These
pads should be washed or changed daily (but only if your doctor has allowed the
brace to be removed for brief periods). Use a mild soap and water to clean the
pads by hand, then pat them dry with a towel and let them air-dry. Replacement
pads can be purchased if needed.
Developed by The Royal Children's Hospital and the Victorian Paediatric Orthopaedic Network. We acknowledge the input of RCH consumers and carers.
Reviewed November 2018.
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