Wednesday, September 22, 2010

After the Spica Cast Comes Off

Dear Les,

I just can't thank you enough for the information you've provided me with. I've been searching the Web like crazy, and most of the stuff I've read is irrelevant!

My son also fractured his femur, but it was due to a bone cyst that he was apparently born with, but that we didn't know about until he had his fall.

He had an operation where they fixed a plate and 8 screws. It has been exactly one month since he had the operation and hopefully we will remove the cast within the coming two weeks.

However, I'm so worried about the coming phase, which is him without the cast. I don't know what to expect, and since it has been 2 years since your son fractured his femure, maybe you can tell me when to expect that he can go back to his old self.

He is 5 and a half, by the way. I hope your son is doing great now.

Thanks again, and I really can't wait to hear from you.



Dear Sasha,

My son has completely recovered; there is no difference in the length of his legs, and he has no trouble walking, running, or engaging in all other activities with children his age.

When the cast was first removed, however, it was a much different story. The healed leg was thinner than his other leg and the muscles had atrophied (the leg in the cast was also strangely hairy).

Akira was terrified when the cast was removed, as he was used to the heavy weight of the plaster. We put a pillow on his legs, and this calmed him as we wheeled him out of the surgeon's office. It acted as sort of a substitute for the cast.

Akira also couldn't bend his leg. In fact, he didn't bend it until the next day (he did it in his sleep).

Whatever you do, don't force him to bend it. The orthopedic surgeon told us that. Let him bend it when he is ready.

Akira laid on his stomach for a few days, just as he had when the cast was on. Then he eventually got up and started walking. Seeing his brothers running and playing around him was his motivation, no doubt.

Our orthopedic surgeon recommended we take Akira to a physical therapist (PT), and we did. We also put him through a little more than six weeks of daily leg-strengthening exercises. I did these at home, and took Akira to the PT periodically to make sure I was doing them correctly. (The surgeon wanted us to do the exercises with the PT at the clinic, but the copay was expensive--and we had to pay it on each visit!--so I asked for a list of the exercises from the PT and put Akira through them myself).

Your son's situation sounds very different from Akira's, however. He is older and he has a cyst, correct? Thus he may take longer to heal (the older we are, the longer it takes) and he may need different exercises than Akira required.

Be sure and ask the orthopedic surgeon. Ask lots and lots of questions.

One piece of advice: be sure he's around playing children after the cast is off. What I mean is, if he doesn't have any siblings near him in age, take him to the park or have him visit friends or relatives his age. Seeing other kids hopping around will give him a reason to get up and get moving again.

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