Name of the Procedure:

• Common Name(s): Pediatric Long Leg Cast (Fiberglass)
• Technical/Medical Term: Immobilization with a Pediatric Long Leg Cast made from Fiberglass (HCPCS code Q4032)

Summary

A pediatric long leg cast is a type of cast applied to immobilize a child's leg from the thigh to the toes to allow for proper healing of fractures or surgical corrections. This specific procedure uses a lightweight fiberglass material.

Purpose

• Medical Conditions Addressed: Fractures, surgical corrections, severe sprains, and bone deformities in the lower extremities of pediatric patients (ages 0-10).
• Goals/Expected Outcomes: To stabilize and protect the affected leg to ensure proper bone alignment and healing, reduce pain, and prevent further injury.

Indications

• Fractures in the femur, tibia, or fibula.
• Post-surgical immobilization.
• Severe sprains or ligament injuries.

• Bone deformities requiring immobilization for treatment.

• Patient Criteria: Suitable for pediatric patients aged 0-10.

Preparation

• Pre-procedure Instructions: Avoid eating or drinking if sedation is required.
• Diagnostic Tests: X-rays or other imaging tests to assess the extent of the injury or surgical outcome.

Procedure Description

1. Initial Evaluation: Assessment of the injury through physical examination and imaging.
2. Positioning: The child is positioned comfortably, ensuring the leg is in an appropriate position for casting.
3. Application of Cast Padding: A soft cotton or synthetic padding is applied around the leg to protect the skin.
4. Application of Fiberglass Cast: Fiberglass casting material is soaked in water, then carefully wrapped around the leg from thigh to toes.
5. Molding and Setting: The cast is molded to ensure proper fit and support, and allowed to dry and harden.

• Tools/Equipment: Fiberglass casting material, padding, water, gloves, and scissors.
• Anesthesia/Sedation: May involve local anesthesia or sedation if the procedure is associated with significant discomfort or if the child is particularly anxious.

Duration

• Typically takes about 30 to 60 minutes.

Setting

• Performed in an outpatient clinic, hospital emergency room, or orthopedic surgical center.

Personnel

• Orthopedic surgeon or pediatrician.
• Nurses or medical assistants.
• Anesthesiologist (if sedation is required).

Risks and Complications

• Common Risks: Skin irritation, swelling, discomfort.
• Rare Risks: Pressure sores, delayed healing, compartment syndrome.
• Complication Management: Regular monitoring, potential cast adjustments, or splitting to relieve pressure.

Benefits

• Stabilizes fractures and aids in proper healing.
• Protects the injured area from further damage.
• Generally well-tolerated given the lightweight nature of fiberglass.

Recovery

• Post-Procedure Instructions: Keep the cast dry and avoid inserting objects into it. Elevate the leg to reduce swelling.
• Expected Recovery Time: Typically, 6-8 weeks for most fractures.
• Restrictions: Avoid weight bearing on the cast if instructed. Follow-up appointments to assess healing and possibly replace or remove the cast.

Alternatives

• Other Treatment Options: Short leg cast, splinting, or surgical intervention.
• Pros and Cons: Splinting is less restrictive but may not provide the same level of immobilization. Surgery is more invasive and involves surgical risks but may be necessary for complex fractures.

Patient Experience

• During the Procedure: The child may feel some pressure or discomfort as the cast is applied, but pain should be minimal.
• After the Procedure: Some initial stiffness or discomfort is normal; pain can be managed with over-the-counter medications. The child will need to adjust to the limitations of the cast but should gradually become more comfortable. Care must be taken to follow all post-procedure instructions to avoid complications.