A toddler in a spica cast; Little broken leg, big adventures…

It seemed like only yesterday that we were in the hospital together, you in your little bed snug as a bug and sleeping it off. Me in the big bed, knowing I should try to sleep but damned if I could. I was in awe and utterly love struck. I made so many promises to you that night, the type that all parents probably do. Little were we to know that three years later, we’d be back in hospital with a broken femur. That little garden step that tripped you up got you good.

Just over four weeks ago, our three year old tripped up in the garden and broke his femur. He was in traction overnight and then a spica cast was put on him under general anaesthetic. We had no idea what this was either, but it was a full leg in cast up over his hips and half way down his other leg. It was much softer than we thought it would be, so protected his leg but didn’t add much extra weight when we lifted him. While we were in the hospital, with our son sleeping fitfully next to us, we found just a few blogs about what to expect with a toddler in a spica cast, along with some useful tips. We thought we’d put our experiences and tips here, hoping that if someone is out there going through something similar, it might just help a bit.

• For the first few days, the body is still in shock from the break so it’s normal to see his body spasm. It hurt him, especially if he was trying to sleep. We moved his bed in to our room for the first few days as he would calm down if he held on to our hands or heard our voices.
• Talk it through with them. We’d ask our son how he was feeling and he would say, obviously, he was sad or angry because he hurt his leg. Not wanting him to hold on to that frustration we put all the pots and pans on a table, gave him a spoon and let him bang it out. We did the same with paints and let him splash it about.
• My husband made a table for our son, that could fit around his pushchair but it meant we could all sit around the table at meal times and he could play with his toys or playdoh.
• There is a trick to the nappies. Get a smaller size and cut off the tabs. Shove this inside the cast up underneath the bum and tuck it in up the front. Then get bigger size nappies to go on the outside. We tended to shove the smaller size ones up the back of the cast during the day only to allow breathability and quick access for wees. It also meant that when he went for a number two, the cast was protected from any poo.
• Our son is potty trained yet the hospital told us not to worry about it, to let him go back to wearing nappies and retrain again afterwards. Our son did not like this idea. Going to the toilet was the only thing he could control in an otherwise crummy situation, and at the end of the four weeks he didn’t have one accident.
• We bought a portable urinal online that our son was able to use. It was cheaper online than any we found from chemists and the likes.
• We got some trousers a couple of sizes bigger, cut up the inner seam and stitched some Velcro along it. We also got some shorts and did the same with those, which he preferred as he wouldn’t overheat in them.
• His foot was really swollen when we first got back from the hospital, so we got him some thick welly socks for when we went out to keep his feet warm.
• In our view, normality was key and we didn’t want him to think his life had to stop because of a sore leg. He still went to his nursery (who were really great with him) on his usual days, if only for a few hours each day. We went to the park, to the cinema, playgroups, for walks in the mountains, to the local aquarium and animal park. When he would say “when my leg is better, we can do this” we always replied “why wait? Let’s do it now”…apart from baths!
• Ok, so not a bath, but dunking his head in the kitchen sink grew to be a favourite. Make sure you’ve got plenty of towels around though!
• To begin with his natural position was slightly reclined, but the more time went by, he was able to sit more upright so that after a few weeks he was back in his booster seat at the table for mealtimes etc.
• Ask the local community nurse for a few more sheets of that fluffy cast padding which can be peeled off and replaced regularly which is nice as it can get a bit smelly.
• Pick them up with a hand under their legs and under their back. Don’t pick them up under their arms as the extra weight pulls down on their legs and undoes all the good that being in plaster is doing.
• We found that after about a week, he was able to crawl about on his stomach, and then a few days later he could get down off the sofa and his bed which was great to see. He had a bit of his mobility back and could get to where he wanted to.
• Cuddles! We put his old baby cot mattress on the floor in the living room and would lie on the floor next to it, head to head and try to have cuddles that way. After a couple of weeks, once the initial ‘fix’ had happened, it was much easier to hold him close.

Our son had the cast on for four weeks only, and it was taken off last week. Because the cast was a soft cast, they were able to use shears to remove it rather than a saw. We didn’t know what to expect so took earphones and a tablet with us to the hospital, as well as books and his favourite toys on the day, thinking it would be a useful distraction. When the cast was removed it was a bit scary for him, as his ‘armour’ was suddenly not there anymore and every small movement resulted in him shouting and getting teary. He said he was scared and his knee was stiff, so we’ve been taking it slow this week with plenty of hot baths.

These last few weeks have been an emotional rollercoaster of a ride. It happened so fast, and in the garden of all places. I’ve felt hugely guilty that this happened in the first place. We’ve fallen more in love with our son and seen how he’s coped with this sudden change in his lifestyle. I’ve gotten defensive and angry, as only mama bears can at the criticism and judgement thrown our way since the accident. People who don’t know us seeing a healthy looking child in a pushchair and saying we’re lazy parents for not getting him out. People that do know us saying it’s no surprise because we do so much with our son so it was bound to happen really didn’t help!

I’ve gone over and over that day. I would change a hundred things about that day, but taking him out in to our garden is not one of them. We love being outdoors, playing outdoors, experiencing the outdoors. That is something we do every day with him and it’s something that he carried on doing, even with a spica cast. The over riding message we wanted him to come away with was bigger than anything anyone else did and said. He can do it, and apart from a blooming sore leg he was otherwise fit and healthy. It was same same, just different.

I’m not going to lie and sugar coat it. It’s been a steep learning curve for him and for us too, to work with him to figure out what works for him. It’s not always been easy and there have been some good days and bad days. We’ve said it’s like the sleeping pattern of having a newborn baby (up every four hours or so) but having a demanding and active three year old to entertain during the day.

Now the cast has been removed, it’s definitely a case of baby steps and we’re starting to wonder this is where the hard work really begins. He starts his physio later this week so we’ll see how that goes.

***Please note: This is a blog that was previously published on another of our blogs Adventurous Little Legs, and linked to an online store we also had. We have closed these both down. All content and pictures remain those of Stacey and Keith at Adventurous Little Legs and An Outdoors Family.