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Fully Waterproof One-Leg Spica Cast for Femur Fractures

March 01, 2020

Contributors: EYTAN MENDELOW, BS; Jennifer Rachelle Ristic, PA-C; Violet Wallerstein; Barbara Minkowitz, MD, FAAOS

Waterproof casts are becoming more commonly used; however, much of the literature discusses waterproof cast protectors rather than waterproof casts. Waterproof casts are highly rated by patients, parents, and physicians because they are associated with increased comfort and very minor risks. The risks of a waterproof cast include higher temperatures during cast removal and an increased risk of the cast saw touching the patient because cotton padding is not used as a protective layer with waterproof casts. This video is the first demonstration of a waterproof one-leg spica cast. The cast is placed on a 2-year-old patient with a femur fracture. The patient experienced leg pain after his brother jumped on him. Radiographs revealed a spiral femur fracture. The patient underwent fracture reduction and was placed in a spica cast. The patient was brought into the operating room in good condition, and general anesthesia was administered. The femur fracture was evaluated, and closed reduction was performed. A fully waterproof one-leg spica cast was applied on a spica table using an AquaCast liner and 3M fiberglass casting tape. At 2 weeks after cast application, the fracture showed good signs of healing, and the patient was able to bathe and swim. Waterproof casts are associated with many benefits. Further demonstrations of these casts may lead to increased use. In our practice, no complications have occurred on cast removal.

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