How is a Hip Spica Cast Taken Off?

It is finally time, after 18 weeks in a body cast for hip dysplasia, it is time for the hip spica cast to be taken off.

Monday morning was the early start, we know the procedure nil by mouth, so distracting Erin asking for milk is always a great start!  Coupled with it being Dylan’s 8th birthday saw us up and unwrapping gerbils all before 6.30 am.  Once said gerbils had been introduced to their new owner it was time to make a quick exit to childminders and the hospital.

Having the hip spica cast taken off was actually far more traumatic than I imagined it would be.  Since we are now regular visitors to children’s ward Erin was keen to get to the playroom which doesn’t open till 8.30 am. 

Prior to the removal, Erin’s surgeon came to see us and we managed a quick chat with him and he explained he will next operate on her hip in late spring – I do love these non-committal conversations I have with doctors and specialists. We knew this was her treatment plan and that she was scheduled for a salter osteotomy and further six weeks in spica.

Preparing to take off the hip spica cast

The spica cast was being taken off on the children’s ward, she did not need a general anethestic as they were not doing any invasive procedures at this point.

The first stage is that Erin had some sedative drawn up, which apparently tastes grim and she was given it orally.  Erin wasn’t allowed in the playroom once it had been administered and had to stay in the cot as children will just suddenly become drowsy and cannot be left alone. 

As soon as she was asleep I was instructed to call the nurse for her SATs to be monitored.  I watched and waited and then Erin started giggling and became happy, that lasted all of two minutes and then she became distressed and upset. 

After one hour of screaming, crying and pulling the monitor leads everyone agreed that the sedative was not having the desired effect.  At the same time, the plaster technicians arrived to do their job.  They decided as Erin was already distressed just to plough on and get it off. 

Erin cried throughout the 20-minute removal, the bar across her knees was removed first.  Then the saw cuts up through the fibreglass ready to be plied apart.  The process is noisy, dusty and stressful. 

My back knows just how heavy Erin has been these past four months and finally, I could see why.  The hips and legs were encased in plaster of paris and then fibreglass is layered on top. 

As they carefully moved away the casing that has weighed us all down I could see a massive blueish mark on her leg I immediately thought that somehow she had been cut or badly bruised.  Then I saw it was the remains of the big blue arrow that had been drawn on in October. This was to make sure they operated on the right side of her body!

Once the cast was off I found myself in tears at seeing her legs once again. The plaster technician even gave me a hug as I was quietly sobbing but trying not to look stupid!  I didn’t expect this outpouring of emotion yet again!  One thing with DDH is that it is the craziest and silliest things that have reduced me to tears.  Like when it snowed and I thought Erin should be out there enjoying it.

Once off and alone I was extremely worried about hurting Erin.  I didn’t know how to hold her, how to pick her up by and how to postition her.  The nurse just said I’d find my own way and left us to it. 

I had taken flannels to wash Erin and she was demanding toast like she always does.  As the sedation hadn’t worked they were happy for me to go home!  So after a quick rinse of her legs, I popped another dress on her and we left.

Since being at home it has been an incredibly tough few days, sleep doesn’t come easy and Erin is very tender.  She can’t move really and isn’t yet trying.  It is early days so I won’t rush her.  Erin can’t roll or sit unaided she doesn’t have the strength.  In fact, she is needier this week than she was in the cast.

The hip spica being taken off was very stressful and many don’t know what to expect. Erin’s skin was very very flaky and dry. Her legs were hyper sensitive to touch and she was not happy.

Physically she had very little muscle left and because on the length of time she had been in spica her legs could not come together.

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