Name of the Procedure:

Common Name: Short Leg Cast
Technical Term: Short Leg Cast, Pediatric (0-10 years), Plaster (HCPCS Code Q4039)

Summary

A short leg cast is a medical device used to immobilize and support a fractured or injured lower leg in children aged 0-10 years. Made from plaster, it encompasses the lower leg from below the knee to the toes, maintaining bone alignment and preventing movement to facilitate proper healing.

Purpose

Medical Conditions or Problems Addressed

• Fractures in the tibia or fibula (lower leg bones)
• Severe sprains or strains
• Post-surgical stabilization
• Correction of congenital deformities

Goals or Expected Outcomes

• Stabilize and immobilize the injured area
• Promote optimal bone healing
• Alleviate pain and prevent further injury

Indications

Symptoms or Conditions

• Visible deformity or swelling in the lower leg
• Severe pain upon movement or weight-bearing
• Limited range of motion
• X-ray or diagnostic imaging confirming fracture

Patient Criteria

• Children aged 0-10 years with lower leg injuries
• Patients requiring immobilization for healing

Preparation

Pre-Procedure Instructions

• No specific fasting or medication adjustments necessary
• Notify your doctor of any allergies or medical conditions

Diagnostic Tests

• Physical examination
• X-ray or other imaging studies to assess the injury

Procedure Description

Step-by-Step Explanation

1. Cleaning of the Affected Area: The injured leg is cleaned and dried.
2. Padding Application: Soft cotton padding is applied around the lower leg and foot to ensure comfort and protect the skin.
3. Plaster Application: Plaster bandages are wetted and wrapped around the leg, starting from just below the knee down to past the toes. The plaster is molded to the leg's shape.
4. Setting: The plaster is allowed to set and harden over a few minutes, forming a solid support structure.
5. Final Adjustment: The cast edges are smoothed, and any necessary modifications are made for comfort.

Tools and Equipment

• Soft cotton padding
• Plaster bandages
• Water for wetting plaster
• Scissors for trimming

Anesthesia or Sedation

• Generally not required, unless the child is extremely anxious or uncooperative

Duration

• Typically takes about 30-45 minutes to complete

Setting

• Performed in a hospital, outpatient clinic, or orthopedic office

Personnel

• Orthopedic surgeon or physician
• Nurses or casting technicians

Risks and Complications

Common Risks

• Skin irritation or pressure sores
• Itching under the cast

Rare Risks

• Compartment syndrome (increased pressure within the muscles)
• Delayed or improper bone healing

Management of Complications

• Monitoring for signs of complications
• Immediate removal and replacement of the cast if necessary

Benefits

Expected Benefits

• Proper alignment and stabilization of the fractured bones
• Pain relief and prevention of further injury
• Faster recovery and rehabilitation

Timeframe for Benefits

• Bone healing typically begins within a few weeks, with complete union in 6-8 weeks for most fractures

Recovery

Post-Procedure Care

• Keep the cast dry and clean
• Elevate the leg to reduce swelling
• Avoid inserting objects into the cast for scratching

Expected Recovery Time

• 6-8 weeks on average

Restrictions and Follow-Up

• Follow-up appointments to monitor healing and make any necessary cast adjustments
• Restrictions on weight-bearing and physical activity as advised by the doctor

Alternatives

Other Treatment Options

• Removable splints or braces

• Surgery (in case of complex fractures)

  Pros and Cons

• Splints/Braces: Less restrictive, but may not offer the same level of immobilization.
• Surgery: More invasive with longer recovery but necessary for severe cases.

Patient Experience

During the Procedure

• Little to no pain; mostly a sensation of pressure while the cast is applied
• Children may feel anxious, requiring comfort measures

After the Procedure

• Initial discomfort from immobilization
• Itching and warmth as the cast sets
• Instructions on pain management, often with over-the-counter pain relievers