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

1. Anesthesia: General or regional anesthesia is administered to ensure the patient is comfortable and pain-free.
2. Positioning: The patient is positioned appropriately to access the affected area.
3. 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.
4. 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.