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Our three-year-old son fell and broke his little thigh bone. He's not very old but he's a big child (weighs almost 50 pounds). They say he'll be in a cast from hip-to-toe for at least four weeks. How in the world is my daughter going to manage this? He's not potty trained yet. I'm trying to find any information for her that I can before he goes home from the hospital tomorrow.
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Fractures of the femur (thigh bone) in young children often require a special hip-to-toe cast called a hip spica cast. A special cut-out is made so the child can eliminate body wastes (urine, feces). But because the child cannot bend at the waist, using a potty chair or toilet usually isn't possible. Most parents continue to use diapers during this time of immobilization.
The nurses at the hospital will give your daughter (and any other caretakers such as yourself) an inservice on care of the cast and child. Usually some written materials and reminders are sent home. Some hospitals provide a video with instructions, ideas, and tips for the care of a child in a hip spica cast.
One key issue is keeping the cast dry and free of urine or stool. Skin breakdown associated with spica cast application can occur as a result of urine or feces getting under the cast or soiling the edges. Moisture and chemicals from urine and stool irritate the protective outer layer of skin. Additional complications can occur if bacteria entering open cracks or sores and cause infection.
Special diapering techniques are usually demonstrated to the parents and caregivers. Proper positioning is also important to prevent skin problems. Again, the information should all be provided in written (if not video) form. Don't hesitate to contact the nursing staff if you need help.
Any visible sign of skin irritation (rash, redness, bleeding) should be checked right away. This is usually done by the nursing staff or physician. Since skin problems can develop under the cast in places where it can't be seen, a fussy baby or as in this case, young child may be an indication of a problem. It may be necessary to remove the cast, take care of the skin problem, and recast the child. Again, early recognition of the problem and immediate intervention is the key to preventing more serious complications.
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*Disclaimer:*The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. |
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