Casting
Casting
Scottish Rite for Children’s team of casting experts is skilled in creating and applying casts for fractures, scoliosis and hip dysplasia. Casting may also be part of follow-up care after surgery to correct limb differences and many other issues. Our cast technicians work closely with our sports medicine, general orthopedics and fracture care providers to ensure your child receives appropriate, comprehensive care for their needs.
Casting Services
Your child may need a cast for many reasons. Casts:
- Keep a body part from moving
- Help stretch muscles
- Help broken bones heal
- Protect a bone or joint that was recently operated on and allow it to heal
You and your child will work with our cast technicians and our dedicated child life specialists, who will help your child understand the process and ease any worries your child may have about the process.
Cast Care
Scottish Rite provides many types of orthopedic casts for children, including arm, leg, scoliosis, spica, Petrie and body casts. We offer comprehensive support from your child’s first visit to their cast removal, physical therapy and beyond.
Arm Casts
Children who need arm casts may receive one of the following types:
- A short arm cast that extends from the hand to just below the elbow
- A long arm cast that extends from the hand to above the elbow.
Your child may also receive a sling to wear for a few days.
To help your child heal, keep the following tips in mind:
- Keep the arm elevated so the elbow is higher than the heart and the hand is higher than the elbow. This position will help prevent or reduce swelling.
- When using a sling, make sure the elbow rests against the back of the sling.
- Ensure your child’s hand stays at chest level when using the sling. Have your child sit down and elevate the arm if their hand or fingers begin to swell.
Leg Casts
Children who need leg casts may receive one of the following types:
- A short leg cast that extends from the foot to just below the knee
- A long leg cast that extends from the foot above the knee
- A walking cast that allows your child to bear weight on the foot but must be worn with a cast shoe
- A non-walking cast that requires your child to use crutches, a wheelchair or a walker to move around
While your child has a leg cast, the following tips will help them feel more comfortable until the cast comes off:
- Elevate the leg to reduce swelling. Have your child keep their injured foot above their knee and heart throughout the day and night.
- Keep pressure off the heel to reduce the risk of pressure sores. Your child’s heel should float in the air. If your child is on their back, you can place pillows or a rolled towel under the calf. If your child is on their side, place a thin pillow between the legs.
- Cover the cast with a sock to keep it clean. However, remove the sock regularly to check your child’s toes for swelling, changes in color and numbness.
Petrie Casts
Petrie casts are long-leg casts used in children with Perthes disease. They are applied to both legs and hold the hips in an “A” position to help reduce inflammation as your child heals. Petrie casts extend from the upper thighs to the ankles and typically have a bar between them to keep the legs and hips in the right position.
Your child may wear a Petrie cast for four to six weeks. You’ll need to have a large car or van that fits your child comfortably, and you will need to have adaptive clothing that fits over the cast.
When your child has the Petrie cast, do not use the bar to lift or move your child, as it may break off.
Scoliosis Casts
In children who have scoliosis, casts can prevent a spinal curve from worsening while a child grows. They generally work more effectively in very young children.
When your child receives a scoliosis cast, they will have anesthesia so the doctor can correct the curve with traction before applying the cast. Your child may need to stay overnight at the hospital, or they may be able to go home the same day as the procedure.
Unlike a scoliosis brace, you can’t remove a scoliosis cast, and it may take a few days for your child to adjust. The cast may affect their balance and walking. Close supervision is important to prevent injuries from falls. Your child will adjust to the cast in a few days. Scoliosis casts have large windows that allow the stomach and lungs to expand to reduce discomfort.
Children may need to wear a scoliosis cast for up to a year, and they will receive a new cast every two to three months. During that time, you will need to give them sponge baths, rather than regular baths or showers, to keep the cast from getting wet and protect your child’s skin from moisture. If your child wears diapers, tuck the diaper under the cast at the hips.
Spica Casts
Spica casts help ensure proper hip joint positioning in children with developmental dysplasia of the hips. They can also be used when a child has broken a femur or after other types of hip or pelvic surgery and are generally applied during surgery, when your child is under anesthesia.
The casts extend from just below the chest down to the hips and legs. Some spica casts have a bar that keeps the legs and hips in the right position.
Spica casts require a lot of care. Your Scottish Rite casting team will give you thorough instructions for helping your child while they have the cast, including advice on using diapers or helping potty-trained children use the bathroom.
Your team also includes an occupational therapist who can help you access equipment, such as a car seat or special seatbelt, and give you tips for going about your daily activities.
Helping Your Child With Cast Removal
Cast removal can be an intimidating experience for kids. Scottish Rite’s child life specialists and cast care technicians will walk them through the process and explain the equipment using age-appropriate language to help reduce their anxiety.
We encourage parents to bring items from home to ease the process, such as:
- A blanket or stuffed animal
- A bottle or pacifier
- A favorite book
- A phone or tablet with your child’s favorite music or movies
- Noise-canceling headphones
After the cast is removed, your child may need X-rays. Depending on their condition and treatment, they may have another cast applied or begin physical or occupational therapy.
If your child is not receiving another cast, here are a few things to keep in mind in the days and weeks after cast removal:
- The arm or leg that was in the cast may appear smaller than the other arm or leg. It may also be stiff or sore for a few days after the cast comes off.
- Your child’s skin may be very dry or flaky. You can apply lotion to help prevent your child from picking at or scratching their skin.
- Your child’s doctor will let you know when your child can take a bath or shower. Keep the water temperature warm and pat the skin dry.
- Your child’s skin will be very sensitive, so use sunscreen when outdoors.
Find more tips in our guide to cast removal. (en Español)
