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A Method of Shoulder Spica Cast Application In Shoulder Muscle Transfer Patients In Supine Position
Harsh R Shah1, Praweshi Singh Bhandari2, Mayur Goklani1
1Department of Plastic Surgery, Bombay Hospital and Institute of Medical Sciences, Mumbai, India.
Insights
A novel technique simplifies applying shoulder spica casts for infants with birth brachial plexus injury (BBPI). This method uses readily available materials and avoids position changes, easing the procedure for anesthesiologists.
Area of Science:
- Pediatric Orthopedics
- Neurosurgery
- Medical Device Innovation
Background:
- Children with birth brachial plexus injury (BBPI) frequently need shoulder surgery.
- Post-operative shoulder spica casting is essential after muscle transfer surgery in BBPI patients.
- Current methods for applying shoulder spica casts in the supine position under anesthesia are challenging.
Purpose of the Study:
- To present a simple, cost-effective shoulder spica cast application technique.
- To facilitate cast application in the supine position without altering the patient's position under anesthesia.
Main Methods:
- The technique involves elevating the supine child on a wooden bar under anesthesia.
- Plaster of Paris (POP) rolls are applied cylindrically from the iliac spine to the contralateral shoulder.
- Commonly available materials like a wooden plank, bolsters, and POP rolls are utilized.
Main Results:
- The described method successfully applies a shoulder spica cast without repositioning the patient.
- It eliminates the need for customized apparatus or specialized operating tables.
- The technique is easy to assemble, reproducible, and cost-effective.
Conclusions:
- This technique simplifies shoulder spica cast application for infants with BBPI.
- It offers a practical, economical solution for surgeons and anesthesiologists.
- The method is adaptable and can be implemented in various settings.
Abstract:
Background Children with birth brachial plexus injury (BBPI) often require secondary surgery for the shoulder. The shoulder spica is necessary after shoulder muscle transfer surgery in babies with BBPI. However, its application can be difficult in the supine position under anesthesia. The authors describe a simple and cost-effective method of applying the shoulder spica cast without changing the supine position under anesthesia. Technique While still under anesthesia, the child is placed in a supine position and then elevated on the wooden bar. The POP roll is wrapped around in a cylindrical manner, starting from the level one inch above the anterior superior iliac spine. The contralateral shoulder is also incorporated into the cast. Conclusion The spica application technique described comprises commonly available materials, such as a wooden plank, pair of bolsters, plaster of Paris rolls, and dressing materials overcoming the need for customized apparatus or the operation table. The materials are easy to assemble and thereby applicable just about anywhere. The task also becomes less challenging for the anesthetic in the supine position. This technique is easily reproducible and cost-effective.
