• It puts the pieces of broken bone in the right position to grow back together.
• It can ease painful muscle contractions.

–http://kidshealth.org, Nemours Foundation

The answer:  joints (for example, wrists, elbows, knees). The joint above and  the joint below the broken bone must be kept still in order for the bone to heal.
–www.nationwidechildrens.org

A cast has two layers: a soft layer of padding to protect the skin and a hard outer layer that keeps the broken bone from moving.

The outer layer is made of plaster or fiberglass.

• Plaster casts are made of Plaster of Paris, a white powder. Plaster casts are heavier than fiberglass. It's easier to write on them!
• Fiberglass casts are lighter than plaster casts. They come in an array of colors.
• Purple and hot pink are girls' favorite colors. Boys like blue; green camo, too.
         –Parker Medical Associates, a nationwide supplier of fiberglass casting materials
• Plaster and fiberglass come in rolls or strips. The doctor or technician wets the material and wraps it around the soft padding that's already on the broken body part. The material gets hard quickly.

Moms on Facebook's DDH Hip Dysplasia page chimed in with answers: depending on the age and size of the child, a spica cast can weigh from 2.5 lbs (11-month baby) to 12 lbs (5-year-old).

• If the cast gets wet, it may weaken and be unable to keep the injured bone in place.
• If the cotton padding gets wet, it's slow to dry out. Wet cotton padding might cause a rash or infection.

Never put anything inside to scratch the skin. Never put creams or powders in the cast to try to help the itching.

One thing you can do safely: use a hair dryer on the "cool" setting to blow air into the cast. This often provides relief.  –The StayWell Company, LLC via Nationwide Children's Hospital

CastCooler® is a device said to relieve odor, itch and skin rash by keeping cast linings dry. For information and to purchase.

"The outer shell is taken off in pieces by a loud saw with a dull, round blade that vibrates. The vibration is strong enough to break apart the fiberglass or plaster, but it can't hurt [the] skin. It may even tickle."
                –Cool Cast Facts, KidsHealth, Nemours Foundation

Yes, once the cast is off, the injured area will look weird – smaller than normal because of lost muscle, it may be hairy and probably the skin will be dry and flaky.

Children are great healers, so this weirdness is temporary. The doctor or physical therapist may suggest special exercises to regain strength and flexibility. Or, children may get back to normal all by themselves.

Your child's pediatrician and/or orthopedic surgeon!

• www.orthokids.org
• www.nationwidechildrens.org
• http://kidshealth.org

• http://hipdysplasia.org/developmental-dysplasia-of-the-hip/other-resources for parents/
• www.SpicaLife.com – includes videos, Q&A, and must-have gear
• www.ivyrosespicachairs.com/101thingstodo.htm

Fabulous Facebook spica cast support groups:

• DDH-Hip Dysplasia-Children Facing Surgery or Spica Casts
• DDH Support Spica Warrior (based in the UK)

The largest and strongest bone in the body, the thigh bone is called the femur (FEE-muhr). A sudden strong impact can break the femur. That's what happened to Sammy.

The highest risks for children's femur fractures are:

• Falling hard
• Getting hit in contact sports
• Being hurt in a motor vehicle accident
• Child abuse  –OrthoInfo, American Academy of Orthopaedic Surgeons
• Femur fractures in children peak at ages 2-3. Why? Young children carelessly run fast without looking...climb higher than is safe...dart into the street.
                      –American Journal of Public Health, April 2004

Treating femur fractures: spica (SPY-kah) cast
Treating a child's femur fracture involves lining up the pieces of thigh bone and holding them in place until the bone is healed. In children between 7 months and 5 years a spica cast is applied to keep the broken pieces in the right position until the bone is healed. This is the cast Sammy wore.

• There are different kinds of spica casts, but in general they begin at the chest and go all the way down the broken leg to the ankle. The cast may also go down the uninjured leg, or stop at that leg's knee or hip.
  –OrthoInfo, American Academy of Orthopaedic Surgeons
• Because young children's bones grow rapidly, the bone ends don't need to be perfectly lined up. The bone will "remodel" (form new bone) over time, making the broken bone as good as new.
• Most infants and young children will need to wear a spica cast 4-6 weeks for adequate bone healing.
• Children ages 5-8 may also be treated with a spica cast, or an orthopedic surgeon may recommend surgery to insert flexible rods into the bone. –http:Orthopedics.about.com

Spica casts are also used to treat children with Developmental Dysplasia of the Hip (DDH).

Great resources for caring for a child in a spica cast:

• http://hipdysplasia.org/developmental-dysplasia-of-the-hip/other-resources for parents/
• www.SpicaLife.com – includes videos, Q&A, and must-have gear
• www.ivyrosespicachairs.com/101thingstodo.htm

and
Two terrific Facebook spica cast support groups:

• DDH-Hip Dysplasia-Children Facing Surgery or Spica Casts
• DDH Support Spica Warrior (based in the UK)

Not every child in a cast like Sammy's – a spica (SPY-kah) cast – has a broken leg. Some children, even babies, are in a spica cast to treat hip dysplasia (dis-PLAY-zuh). Hip dysplasia is a condition in which the bones of the hip joint aren't lined up properly. If untreated, it can lead to serious hip pain and problems later in life.

Of every 1,000 infants born each year in the United States, 2-3 will require treatment for hip problems.

• They often undergo surgery(ies) and several periods of wearing a spica cast, a brace and/or a harness.
• While Sammy and other broken-leg children can say good-bye to their cast in a matter of weeks, hip dysplasia children have much longer treatments and recoveries.

Sammy applauds these brave children...and their families!
and
Sammy recommends a fanciful book, Hope the Hip Hippo by Gina Jay and Julie Beattie, for children in treatment for hip dysplasia. www.hopethehiphippo.com

The American Academy of Pediatrics (AAP) has taken a strong stand against the recreational use of trampolines: they're too dangerous.  The Academy's findings:

• 98,000 children had trampoline-related injuries in 2009.
• Children ages 5 and younger accounted for 48 percent of all trampoline injuries resulting in broken legs or spine. –https:www.aap.org/en-us/about-the-aap/aap-press-room/Pages/AAP-Advises-Against-Recreational-Trampoline-Use.aspx

In a 2016 post, Purnima Unni, a pediatric trauma injury prevention coordinator for Monroe Carell Jr. Children's Hospital at Vanderbilt Medical Center, repeated the AAP's warning to avoid recreational trampoline use. But for parents who choose otherwise, she outlined the AAP's guidelines. Among them:

• Only one jumper at any given time.
• Adequate protective padding, properly placed, on the trampoline.
• NO somersaults and flips!
• An adult should supervise trampoline activity. –http://www.mysouthernhealth.com/how-to-stay-safe-on-a-trampoline/