My child's leg is in a plaster. Can they fly?

Air travel in a cast with a fracture is associated with an increased risk of leg swelling in a tight compartment. We have hypothesised that there should be an accessible, universal policy for travel recommendations with the cast supported by high-quality literature. We have checked the 20 biggest airlines looking for their guidance on travel recommendation /restrictions in the presence of a broken leg in a cast, particularly in children. We have also carried out a literature review in the last 30 years to ascertain whether there is the best evidence relating to flying safely with a child in a cast. Nine airlines have an accessible policy on flying in a cast. Most airlines recommend to delay the flight 24-48 h after cast application. Four airlines require splitting the cast if applied 48 h before the flight. None of the airlines have specific recommendations related to children. A comprehensive review of the literature revealed 11 relevant articles. None of those studies were experimental studies on flying with a fracture, only one assessed flying in a cast. We did not find a research study focused specifically on children. The recommendation regarding flying restrictions varies among airlines and often there is no coherent policy available. The existing recommendations cannot be fully supported by experimental studies in the existing literature. Flying in a full cast should be delayed until 24-48 h after cast application. If the flight is an emergency, the cast should be bivalved.