Serial Plastering - experiences anybody?

[nortynamechanger]

My DS (3.5) is starting a 6 week (or more) course of weekly changed plasters on both legs to attempt to correct his problems.

Has anyone eles LO had this? Any advice or tips would be much appreciated.

my DS had 10 weeks of plastering on both legs, but this started when he was just 2 weeks old. what is it they are correcting if you don't mind me asking?

He has metatarsus adductus, amongst other things. In lay terms both his feet are (almost) fixed in a pointing down and in shape. This has caused his calf muscles to shorten, so it is getting worse. He can only stand on tiptoe, which is affecting his balance causing him to stand with an unusual posture bending forward at the waist.

His foot area is very stiff and has to be forced (physio stretching exercises) into position and held several times a day.

Well, FWIW my DS disliked having the casts applied, largely due to the feet having to be stretched in to a new position each time. He was upset when having the casts done and usually a bit unsettled for the rest of that day. Afer that he was always absolutely fine (until the following week!). It might not be so bad foryour DS during the actual casting as you will be able to explain what is happening and he will have some understanding (unlike my then newborn). However, I suspect he might get frustrated with limited movement on a day to day basis- this didn't occur to my DS of course as he wasn't mobile beyond kicking his legs. Good luck, I'm sure he will cope just fine. And, the weeks go quickly it will be over before you know it.

T5, thank you.

Sadly he has learning difficulties so he will struggle to understand what is going on. Also he has so many tests and appts as they try and discover what is wrong he starts to whimper when he sees a hospital bed :-(

The physio thinks he will still be able to walk, they use light fiberglass casts that do not have to be cut off with the electric wheel. He will be given a walking frame to help him balance. I hope this is possible as he is very active and it will drive him (and me) bananas if he is immobile! That is one of the reasons for having it done in the winter, as we are not playing outdoors so much and he won't miss out.

T5, thank you.

Sadly he has learning difficulties so he will struggle to understand what is going on. Also he has so many tests and appts as they try and discover what is wrong he starts to whimper when he sees a hospital bed :-(

The physio thinks he will still be able to walk, they use light fiberglass casts that do not have to be cut off with the electric wheel. He will be given a walking frame to help him balance. I hope this is possible as he is very active and it will drive him (and me) bananas if he is immobile! That is one of the reasons for having it done in the winter, as we are not playing outdoors so much and he won't miss out.

DS was in a plaster cast that was changed 4 times when he was a year-old - not quite serial casting, though.

Not needing to cut the cast off with the circular saw is a huge benefit - breathe a sigh of relief, there! It terrifies most children!

Will they teach him to use the frame and let you have it to practice with before the first cast goes on? That can be v helpful. And if he will need to keep the cast dry ask in the fracture clinic about the waterproof plaster coverings that can be used in the bath. Does he enjoy a bath? As much as can be kept as normal as possible will help, i suspect.

Have you seen the STEPS website and forum? There may be parents of children with the same ocndition there.

DS was funny with his leg in plaster - he was absolutley fine when it went on, just adapted, and was clulnking about, crawling, just as he always had.

But when it came off he was very jittery. He didn't want to put his leg down, and seemed more perterbed by it coming off than going on - so be prepared for that in due course.

Good luck - i hope it goes well.

oh - and don't let him 'post' toast down the cast......that was a nightmare!

Blu, thanks for your comprehensive reply. I'd never heard of STEPS I shall have a look at that.

He used a frame for a short while whilst younger, so I hope he will remember how.

The Physio mentioned the waterproof covers, I was wondering how I was supposed to bath him. He loves his bath and would feel left out if his sister got one and he didn't.

His pre-schools (one SN and one independent)have ramps everywhere so he will still be attending 'school', he has a 1 to 1 in the private one so they are fine with it. The sN one are used to this type of thing.

Did your LO suffer a lot of muscle wastage whilst immobile? I had my arm plastered (broken) and it took years to make my arms the same size again!

So your DS had one leg cast? was this for a break or to stretch/change muscle and foot position (as my Ds' is) it? How long was he plastered for? Did it work if it was stretching?

They originally told me 3-4 weeks but his problems have got more severe over the last few months, hence bringing this forward by a year. I suppose with both legs cast he will have to put at least one foot down once they are off.

Thanks for the tip about the toast, I'll keep an eye on that!

DS was born with Fibula Hemmemelia - lack of a fibula - a short leg and his foot in a talipes position (pointing straight down and the foot twisted inwards, with the top of the foot facing his other foot's instep, iyswim). Because his ankle is also non-standard issue, soft tissue surgery was required to get his foot in a position that would enable him to learn to walk on it - hence having surgery at one, so that once he was out of plaster, he could start to put it to the floor straight away. After the operation he had 4 plaster changes at week or two week intervals, under GA, to push the foot back into a more correct position. Then 10 weeks in thigh length plaster.

He did have muscle wastage - and at times since he has used a splint - this has also caused muscle wastage. But we see a physio regularly and they have been very good at suggesting excercises to encourage in normal life to help keep the muscles strong. She used to suggest all sorts of sneaky ways in every day life to get him to stand on tip toe to excercise his calf muscles.

This is exacerbated in DS because he has some muscles and tendons missing, too as there is nowhere for them to anchor to.

Anyway, the surgery and casting worked very well indeed and he started to learn to walk as soon as the plaster came off.

He's now 6, and will have bone-lengthening surgery later this year - pretty confronting stuff, but also with a very good record of success.

DS is being treated at King's in London.

Thanks Blu, I've been to the website and (like many things) I'm not quite sure where we fit in.

Your DS seems to have a real fighting spirit, learning to walk as soon as plaster off. Good luck with the surgery later this year.

DS had the first plasters done today, fairly light ones not too much of a stretch - just to get him used to them. He has a reverse walker, but keeps just lifting it up and carrying it

He was really good and just watched Thomas whilst they did it. Consists of tubigrip type stuff, cotton wool bandage, hard but rubbery peelable-off bandage, solid plaster layers up the back to keep stable and then more layers of the special new rubbery plastercast.

He got very distresed just before bedtime and I checked the top of the backstrap/block on one was really digging into his leg (had broken the skin) so I have taken the top rubbery layer and hard backblock off. Physio said I could peel it off in an emergency -I didn't think it would happen the first day! I will put another top layer (have some purple sticky bandage from the ponies - poor boy) to keep it neat.

I seem to remember that one of DS's plasters was a bit snug round the top -his was 'real' plaster, and i ground it down with a pumice stone and then put tape over it! LOL at your horse tape.

Also - I remember his leg itched under the plaster for a couple of days / nights. I think this is a common problem, surprisingly piriton calms the itching and it wears off after the first couple of days.

Just use STEPS for the specifics of casting and being in plaster if you need to - the talipes and hip boards will have people who have knowledge of serial casting and spica casts, I think.

I'm pleased your DS wasn't upset by the plaster going on, anyway. DS has casts done every couple of months for the mould for his splints and shoe insole - he loves it!

Let us know how your ds is getting on.