Bones, Joints and Muscles Treatment

Risser and Pantaloon casts are part of the treatment to correct your spinal problem. The casts look like this:

• In a Risser cast, you can sit and walk
• In a Pantaloon cast your hips will not move, so you will not be able to sit or walk

These casts are made from either Plaster of Paris or synthetic materials. The doctor will decide which type of cast is best for your care. Please inform health professionals if your child has a latex allergy.

Living with Your Cast

Learning to cope with your cast will take time. When you first get your cast you may feel that you can't stand it. Try to do as many things for yourself as possible. This may be hard at first, but as you learn to move, dress, etc., you will feel better.

Some days you may feel trapped and sad. Talking with your family and friends about how you feel often helps.

How the Casts are Applied

1. It takes 1 to 2 hours to apply these casts.
2. Two layers of soft fabric are wrapped around your body over the areas the cast will cover
3. For a Risser cast, the material is applied from your chin to your hips. For a Pantaloon cast, the material is applied from the middle of your chest to your knees
4. The cast feels wet, warm and tight at first. This tight feeling will go away as the cast dries. Plaster casts take 2 to 3 days to fully dry. Synthetic casts dry in 2 hours
5. After the cast is applied, the edges will be trimmed. Tape "pedals" may be applied to any rough cast edges to protect your skin
6. Your arms and legs will be cleaned to remove any plaster. Then you will have an x-ray to check your spine's position

Equipment / Supplies

1. From the drugstore you may need rubbing alcohol and moleskin.
2. From a supply store you may need a hospital bed with side rails and trapeze bar. If you are allowed to walk, you may need a walker or, crutches. If you are not able to walk, you may need a cart, or a reclining wheelchair.
3. If you had surgery, you may need a prescription for pain medicine to help you feel more comfortable.

Cast Care

Taking care of your cast is part of your responsibility.

1. Keep your cast clean and dry to prevent skin problems. Do not get your cast wet. Protect your cast by covering it with plastic food wrap while eating, sponge bathing, washing your hair, and using the bathroom.
2. Do not put anything under your cast. Your skin under the cast can be easily scratched and infected. If itching occurs, you may blow cool air under your cast from a hair dryer. If itching still bothers you, call the doctor for a medicine to ease it.
3. Never use lotions, creams, or powders on your skin around or under the cast. This will soften your skin and your cast. Softened skin is more easily scratched and damaged from the edges of the cast pressure.
4. Three times a day, wipe rubbing alcohol on your skin around the cast edges. This will help toughen your skin. If your skin becomes cracked or flaky, stop using the alcohol until your skin appears normal.
5. Infections of your skin under your cast can cause:
1. Sores
2. Drainage
3. A change in the odor of the cast
6. A cast that is too tight or pressing on one area of your body too long can:
1. Slow circulation
2. Press on your nerves
3. Cause pressure sores

Several times a day check your arms and legs for changes in their color and temperature, ability to move, numbness and tingling.

Personal Care

You will need some help to take care of yourself. As you become used to your cast, you will be able to do more things by yourself.

Every day wash all parts of your body not covered by the cast. Brush your teeth. Wash your hair as needed. Remember to protect your cast from getting wet.

If you cannot be out of bed, you will use a bedpan or urinal. The nurse can show you how to use a bedpan.

1. Turn on one side.
2. Place the bedpan on the bed.
3. Roll onto your back onto the bedpan.
4. Tuck a diaper around the cast to protect it and funnel waste into the bedpan.
5. A pillow in the middle of your back will help ease pressure on your head and buttocks while using the bedpan.
6. Never place a pillow under your head when in a Risser cast. It will force the head forward and cause pressure on the chin and jaw.

Meals

1. Avoid junk food. A balanced diet will help to keep you healthy.
2. Eat small meals often rather than three large meals. This will help prevent feeling too full while you are in your cast.
3. Drink extra fluids. This will help you go to the bathroom regularly.

Activity and Safety

As you become used to your cast, start doing more things for yourself. The key is to be as active as possible while protecting yourself from injury.

1. Your cast may be heavy, so your balance may not be even. Use a walker, handrails, or your family to help you as needed.
2. If your bedroom is upstairs, move it into a first floor room if you can. This is important so you can leave quickly if there is a fire.
3. If you are allowed to walk, start slowly and increase your activity by walking first to the bathroom, then to the table for meals, and then within your home.
4. If you are not allowed to walk, use the cart or wheelchair to move around your house.
5. Plan different things to do. Besides watching TV, you can read, have friends visit, play games with your family, work puzzles and do your schoolwork.

Clothing

Use large, loose clothing to cover your cast. Elastic waistbands work well.

To put on pants, socks and shoes:

1. Sit down.
2. Cross one leg over the other.
3. Pull the clothes over your crossed (bent) leg.
4. Straighten your crossed leg.
5. Now bend the other leg and pull your clothes on over it.

Call the Doctor If

1. A change in position or skin care with alcohol does not make reddened areas go away after an hour.
2. Numbness, stinging, or burning occurs under your cast.
3. A different foul (bad) smell, other than urine, feces, or body odor, comes from your cast.
4. You have pain that is steady or increases, and is not relieved by medicine or a change in position.
5. You have a fever over 101 degrees or more.
6. Your cast becomes soft or cracks.

For Your Family

Learning to cope and live with a cast takes time. Your child may be depressed because of the changes in how she/he looks and feels. Listen to your child and support his/her feelings. Urge him/her to learn to care for themselves as much as possible. For a while, your child may behave differently around other people, but have your family and their friends spend time with your child. Some days may be difficult, but a positive outlook helps.

Follow-up Care

Your doctor will tell you where and how soon you will need to come back for a check-up. If you have any questions call the orthopaedic nurse, or orthopaedic physician.

Contact Us

If you need to reach the Orthopaedic Nurse before 4 pm, Monday through Friday, please call 513-636-4567. After 4 pm, and during weekends and holidays, please call 513-636-4200 and ask that the Orthopaedic Resident on call be paged.

PEP 2024 II 7/88
Rev. 7/06