A shoulder spica cast is used to support the shoulder as it recovers following surgery or injury. It may also be used to stretch a tight shoulder. The cast is usually applied in the operating room while your child is sleeping.
How do I Care for my Child while in a Shoulder Spica Cast?
- Keep the cast dry at all times
- DO NOT place your child in a bathtub or sink – sponge bathe only
- To keep the cast dry during sponge bathing, wrap it in plastic bags and secure the edges using adhesive tape.
- Check your child’s skin at bath time
- Look for red patches (i.e., spots where the cast could be rubbing). These scars are most typically seen between the thumb and index finger, as well as on the back of the belly band.
- Cast padding can compress and move, leaving sharp edges
- If you see any sharp edges, apply moleskin or other padding between your child and the cast to protect the skin (this is known as petaling).
- DO NOT PERMIT YOUR CHILD TO PICK AT THE CASTING OR CASTING PAD.
- DO NOT USE OILS NEAR OR ON THE CAST.
- DO NOT ALLOW YOUR CHILD TO PUT ANYTHING IN THE CAST. Look for things that do not belong in the cast while inspecting the skin around the margins.
- If the exterior of the cast gets dirty, clean it with a gently moist washcloth.
- If you have any skin issues or concerns, contact your doctor.
To prevent food and staining, cover the cast with a cloth while eating.
- Diapers should be tucked UNDER the belly band.
- Wear oversized T-shirts or tank tops.
- Oversized zip-up sweatshirts work well to keep warm (football, skiing, snowboarding, skating, etc.)
- Summer Months/Warm Weather
- Dress your child lightly
- Your child may feel more at ease in air-conditioned places.
- Sweating under the cast may cause irritation. If your child complains of itching, you may use a cold-setting blow dryer to blast cool air beneath the cast.
Check for excellent circulation by doing the following steps:
- Gently press a fingernail on the cast arm. The fingernail should turn white
- Remove the nail. It should return to pink.
- Change your child's posture if the nail does not become pink. Wait a few minutes before checking the fingernail again.
- If your fingernail stays white, blue, or gray, contact your doctor right away.
Cast Edges Petaling
- Petaling involves covering the cast's rough edges to protect your child's skin. There are several types of sticky padding. Moleskin is an adhesive dressing used by certain doctors.
- After the cast has dried, it will be petaled (as required) at the hospital. You may replace the petals or strips at home if they get wet or unclean.
When to Consult a Doctor
If your child exhibits any of the following symptoms, contact your child's doctor:
- Red skin and/or sores around the cast's margins
- Hand or arm numbness or tingling
- Blue or gray color in the fingers
- Cold fingers
- The cast has a strong unpleasant stench.
- Consistent abdominal pain
- 48-hour nausea and/or vomiting
- Complaining that this cast is too tight
- Complaining about persistent discomfort
- Only the medical staff can care for surgical wounds; please keep all bandages in place unless otherwise ordered.
- Begin with scar massage. 2 weeks after surgery, when the incision has healed fully (no scabs or stitches present)
- Apply unscented lotion or oil (e.g., vitamin E, cocoa butter) to the scar with your fingertips, moving in a tiny circular motion.
- Scar massage should be done four times a day for five minutes each.
- If your child will be out in the sun, wear SPF 35 or cover scars for 1 year to prevent tissue discoloration.
Exercises / Therapy
- After the cast is removed, therapy starts 1-2 weeks later. This gives your child time to adjust without the cast. This procedure might take up to 2-3 days and can be unpleasant at first.
- When your child is approved by their surgeon, therapy will begin cautiously by regaining range of motion in the arm and then advance to strengthening.
- To avoid joint stiffness, doctors suggest that children who have just had their cast removed attend therapy 2-3 times per week for the first month. As individuals advance through treatment, this may be reduced.