Broken Femur

My baby (21 mths old) fell and hurt her leg.  We went her to the ER and they took an X-ray and told us she had broken her femur.  We felt sick when we saw the X-ray.  The orthopedic surgeon told us she wouldn't need surgery (what a relief) just a cast, a special cast called the Hip Spica cast.  

With in an hour we were admitted to the hospital and had a room in pediatrics.  They showed us a doll with the cast on to give us an idea of what our baby's cast would look like.  It looked very big and scary.  In order to put the cast on they would need to put our baby to sleep with anesthesia. They put and IV in her arm and we walked her down to the OR.

She was gone for about 2 hours.  We waited in our room and read information given to us about the cast and how to care for it.  After reading the 4 pages I had a lot of questions and wondered if I would be able to care for my baby in the best way possible.  It was all very overwhelming.  

When they brought her to us she was sleeping.  Peacefully.  It was so nice to see her free of pain.  I was worried about the cast but just to see her painless was so nice. 

 She slept for about 3 hours.  

(The doll with the yellow hip spica cast.)

When she woke up she was happy.  Playing with us and talking. She was ok! 

She never liked the IV. She was always trying to pull it out.  

They showed us how to change her diaper and told us to try to get her to drink something.  

Because she had been given anesthesia we had to stay overnight.  

She did pretty good in the hospital but cried most every time the nurses took her vitals because she thought it was going to hurt.  

The next day we went home.  They said her car seat was good enough and the best option.  Her cast was formed in a laying down position not a sitting position so any kind of sitting was hard but especially sitting in a car seat.  We tucked a small pillow behind her to give extra support.  The doctor said he advised against any road trips or excessive travel. 

At home we found that a giant bean bag was the best option for the first 2 weeks.  

(Until she learned how to scoot herself off of it.)  

To keep it clean we covered it with a blanket.  She spent most of the day here.  We even fed her on it.  It was a lifesaver.   

The doctor told us to keep her legs elevated the first few days, to change her diaper every hour to prevent leaks and at night time to change her diaper once a night and change her position twice a night.  

We felt very stressed and overwhelmed. 

After she had been in the cast for 1 week she learned how to roll.  She rolled everywhere.  She even rolled in her crib at night so we no longer worried about changing her positions at night or bed sores. 

Changing her diaper was very stressful the first week.  We figured out a system and it became much easier.  

Her inside diaper was the same size of diaper she wore before her cast.  (The hospital told us to use a size smaller but we found the same size worked a bit better.)  We pulled the velcro tabs off the diapers since we wouldn't be using them and for comfort.  The outside diaper was a size bigger to stretch around the cast and keep the inside diaper in position.  

We made sure to change her diaper every 1-2 hours.  If we ever went longer than 2 hrs we had leaks and wetness.  

Night time was a hard time to keep her dry.  We put blocks of wood under her crib to incline one side of her crib so it would help her pee to run into the diaper and not up her cast. It helped out a lot.  Anytime she would wake up during the night we made sure to change her but never woke her to change her. We had heard about other people who at night would add a maxi pad to their diapers, that did not work for us and created a bigger mess.  

Coping.

(without the outside diaper, duct tapped pads)

The first 3 weeks we spent a lot of time drying her pads around her diaper area and cast out, with a blow dryer.  We even tried a shop-vac for more power.  It was exhausting trying to keep the cast, pads and her skin dry.  

We asked for new pads to replace the dirty ones around the diaper area but that became a problem because the adhesive from the pads tore a hole in the goretex that lines the cast to keep the cotton clean and dry.  So then the cotton would get wet.  We recommend never doing this. Big mistake. After reading a blog online we duct taped all the pads to protect them from getting wet or dirty. If we would have duct taped all the pads right away they wouldn't have gotten dirty and we wouldn't have changed them.   

Duct tape saved our life.  We wish we would have duct taped all of her pads the second we got home from the hospital.  

Since we had a rip in the goretex we had to spend extra time drying out the cast.  A week later we lined the inside of her cast with duct tape where the rip was to protect the exposed cotton.  To do this we cut a long piece of duct tape and stuck one end of the tape to an office ruler and fed it through the cast.  Again the duct tape was a lifesaver and really helped keep the cast clean and dry.  

The top of her cast started to get wet from eating and drinking so we duct taped it so it would stay clean and dry.  It worked perfect! 

Her bar was wood and would also get dirty from her dragging it around everywhere so we duct taped that too. 

The best way for her to spend time outside was in a wagon or stroller.   Not every stroller or wagon would fit her though.  We found a deep wagon she could lay comfortably and safely.

  

The Graco travel system stroller fit her well. 

She loved to lay on her side.  We found her sleeping like this more than once.  

Before long she was army crawling around the house.  We made sure to keep her far away from any stairs.  

                                               

The last 2 weeks she learned how to pull herself up to the couch and stand.  

At her 4 week check the doctor recommended she stay in the cast an extra week (7 weeks instead of 6 weeks) just to be safe.  

3 weeks before she got her cast off, 4 weeks in her cast we were able to do all her buckles up in her cast seat and she fit much better because she had lost weight. 

We still tucked a small pillow behind her back to add support and comfort. 

In the end we did survive the hip spica cast. It was a very stressful 7 weeks of our lives but we made it.  

The day before getting her cast off we let our kids sign it.  

At the doctors office getting ready to cut the cast off.  

She really did very well.  I put her favorite show, Peppa Pig on my phone and she watched it while they cut the cast.  They made 4 cuts, 1 cut down each side of her leg.  Then they pulled the top part off.  She looked down moved her leg a little and started to cry.  She cried on and off until we got her in her car seat.  I'm not sure if it really hurt or if she just didn't want to move it because she was scared it would hurt.  

Life After the Cast

Soon as we got home we put her in the bathtub to clean her up and to help her muscles relax.  She couldn't really sit up with out help for the first 10 minutes but then was able to.  

That first day she still army crawled around the house.  Later that day in the evening she pulled herself up and stood next to her kitchen.  We couldn't believe it! She wouldn't put much pressure on her left leg but we were still very excited she was standing.

It hurt her to bend her knee too far.  She was always very careful to move it. 

Each day it seemed she became stronger and moved her leg just a little more.  

4 days after she started crawling normally.  

1 week after the cast she started taking steps while holding on to the couch.  She would only step on her tippy toes.  She never would put her heel down. 

A few days after that she learned to stand up in the middle of the floor with out assistance. 

She seemed pretty content to crawl and I figured she wouldn't walk for a couple more weeks.  

At 2 weeks after the cast she took at few steps and we clapped and cheered for her.

The next day she woke up and just started walking everywhere.  She limps on her left leg as we expected her to. She now puts her whole foot down, no more tippy toes.  We had read that it might take 4 or 6 weeks we were so surprised she walked so soon!