Application of body cast, shoulder to hips; including 1 thigh
CPT4 code
Name of the Procedure:
Application of Body Cast, Shoulder to Hips; Including 1 Thigh Common name(s): Body cast, Spica cast
Summary
In this procedure, a large, rigid cast is applied from the shoulder to the hips, including one thigh, to immobilize the body and allow bones and soft tissues to heal effectively.
Purpose
Conditions Addressed:
- Complex fractures
- Severe orthopedic injuries
- Post-surgical stabilization
Goals/Outcomes:
- To stabilize the injured area
- Facilitate proper alignment and healing of bones and tissues
- Prevent movement that could disrupt recovery
Indications
Symptoms/Conditions:
- Multiple fractures in the torso or upper leg
- Post-operative care for major orthopedic surgeries
- Severe musculoskeletal trauma
Patient Criteria:
- Patients needing extensive immobilization
- Children and adults with specific complex fractures
Preparation
Pre-procedure Instructions:
- Fasting if general anesthesia is required
- Stopping certain medications as advised
- Undergoing diagnostic tests such as X-rays or MRI
Procedure Description
- Anesthesia: General or regional anesthesia is administered to ensure the patient is comfortable and pain-free.
- Positioning: The patient is positioned appropriately to access the affected area.
- Application:
- Padding material is applied to protect the skin.
- Plaster or fiberglass is soaked and wrapped from the shoulder down to the hips and one thigh.
- The material is molded and allowed to harden.
- Completion: Once the cast is set, it is checked for proper fit and comfort, and the patient is monitored as they awaken from anesthesia.
Duration
Approximately 1-2 hours.
Setting
Performed in a hospital or surgical center.
Personnel
- Orthopedic Surgeon
- Anesthesiologist
- Nurses and Cast Technicians
Risks and Complications
Common Risks:
- Skin irritation or sores
- Restricted blood flow
- Discomfort or tightness
Rare Complications:
- Compartment syndrome
- Nonunion or malunion of bones
- Deep vein thrombosis
Management: Regular monitoring and prompt medical intervention if complications arise.
Benefits
Expected Benefits:
- Proper alignment and stabilization of fractures
- Effective immobilization to facilitate healing
- Reduction in pain over time
Realization: Benefits typically begin to manifest within a few weeks as healing progresses.
Recovery
Post-procedure Care:
- Regular follow-up appointments to monitor healing
- Skin care around the edges of the cast
- Keeping the cast dry and intact
Recovery Time:
- Typically 6-8 weeks before the cast is removed
- Restrictions on activities to avoid disrupting the cast
Alternatives
Other Options:
- Bracing or splinting
- Surgical fixation with plates and screws
Pros and Cons:
- Bracing may offer more flexibility but less stability.
- Surgical fixation is more invasive but may offer quicker recovery.
Patient Experience
During Procedure:
- Patient is under anesthesia, so no pain or awareness during the procedure.
After Procedure:
- Initial tightness and discomfort
- Possible itching under the cast
- Pain management with prescribed medications
Comfort measures include proper padding, careful cast application, and follow-up to ensure adjustments if needed.