United Brachial Plexus Network, Inc.

I'm hearing alot of talk about splints & velcro after the mod/qod at TCH. Just wondering if initially your children were put into a spika cast & then given the splint or did they leave the hospital with the splint?
My daughter Ashley just had this surgery Nov 8 & she is in the spika cast which is not scheduled to come off until Dec 10. Just wondering why the different techniques? Any thoughts would be highly appreciated.
Also my daughter had her surgery at Boston Childrens.
Thanks ALot Everyone!!

Hi Melissa,
TJ had surgery with Dr Waters this past January, I questioned him as to why a hard cast versus a soft splint, since Texas does it this way.
He basically said it was because they didn't want the surgical area touched, and to allow the surgery site to heal uninterupted. This worked great for us, I didn't worry about TJ falling over, or down or getting hurt- he was up and running in a couple of days-- but I hear the same things about kids in soft splints so go figure!! lol
Now Texas does the soft splint so that ROM'ing can continue even after the surgery-- I don't know that one way is better over the other, I think families factor that into their choice for surgery.
TJ didn't lose function from being in the spica cast, he actually came out with more function and in a matter of a few days it's just been amazing ever since. I'm sure families from TX can say the same about their kids and their surgeries. I think it's really just preference for the doctor, and what they have found to work in their experience.
You'll notice too that the positioning of spica casting and the soft SOL slint is quite different too. I wonder if this makes any difference in needs for future surgeries, but I guess no one can really tell that indefinetly. Great questions to e-mail both Dr Waters and Dr Nath.

Thanks Jamie!!! I've been pondering on this for the last couple days. Your info was very helpful. So the children with the splints must get to have baths vs sponge bathing like we've been doing with Ashley? I don't think the splint would have been effective for our situation cause if she knew it could come off we would probably get more of a hard time. To add a little humour to it though its funny when she falls over cause she yells for me to pull her up cause she's so top heavy LOL & she's almost 3. Some things are kinda funny. I guess I was just curious at the difference. Boston does it their way for a reason thats important I'm sure & i'm okay with that. Also do you have any suggestions for skin irritation? Ashley already has some skin blistering on her right shoulder from friction, its a very small area but I'm concerned cause we still have a little over 3 weeks left in the cast. We have set up a calendar for Ashley to mark her days because we're all so very excited & have heard wonderful things about secondary surgery. Anything you want to share or anyone else would be very helpful. Oh one more thing 5 days post-op & we don't have to give ANY pain meds...is that awesome or what??? Melissa

Thank You Very Much Mary

Thanks Again Mary...I've been taking the alcohol pads and rubbing around the cast where her skin is although I can't do this to the edges around her back because its so irritated & I beieve it would sting her. I'm going to try some more mole skin around that area until it heals enough to rub the alcohol over it. SHe keeps saying it itches & she trys to scratch but can't reach. I'm trying to coerce her into leaving the house tomorrow..fingers crossed I hope she will. It took 3 days to get her to walk to the bathroom..but I think that was the codeine..so glad she's off that.
Anyway thanks again...Fill me in after the cast comes off your little one.

Gotta get used to this logging in thing...

Another question is when they take off the spika cast are they sent home in a splint for another 4-6 weeks?
I've heard some of the parents who go to TCH say something about the 2nd part of the 6 weeks post-op?
Its so strange how things are so different post op but its the same surgery. Any info on this will be helpful too. Hope I'm not being a pain in the butt, but when my daughter had the nerve graft done at 4 mths I knew of no support groups so I didn't have anyone to bombard w/ question after question. Its nice to know I can get some answers here that are very helpful.

We used mole skin on a couple of places, and I went around especially under the arm on his uninjured side. We really didn't notice much of anything that irritated him, if you aren't too far, call Waters and have the cast trimmed-- or see if there is another ortho in the area that can do it, it's probably just a quick fix. TJ didn't do too bad for itching, although a few time *lol* he'd use utensils on his back at dinner to scratch if I wasn't right there watching.
There was no splinting process after- they do offer the older kids a fabric sling after, but they recommend they not use it after a couple of days. The only thing we were told not to do was intentional hanging (like monkey bars)- at his 3 month post op appointment, we were told let him do anything and everything and not limit him. Feel free to e-mail me anytime!