United Brachial Plexus Network, Inc.

I am a therapist who recently removed the SOL (statue of liberty) cast from a 18 month old who had surgery at TCH. Her mother had no idea of what to expect...instant cure,decrease of function, or what! Her child wanted the cast back on at first, but about 15 minutes later, was happy to have her freedom. She rarely complained of the cast or any pain post surgery, but did complain of discomfort after the cast was removed...she also experienced some swelling in her deltoid. My question is whether anyone out there had this happen when a child first was allowed to move her arm after mod-quad and 6 weeks in the SOL cast?

A lot of us have taken off the SOL splint and put our kids immediately in warm baths or warm pools to help the discomfort. We also tell parents to give some tylenol before to try and minimize the discomfort.

Some kids do well immediately but many kids have discomfort and have even more discomfort the next day. Usually we say to parents to give their children time to get used to it - a week is not uncommon.

A lot of work was done in that surgery and the arm was in that SOL position for a long time- so it's just logical that it's going to take a little time getting used to being down.

If you are interested in talking to my daughter's OT about this email me and I will give you her phone number. francine@injurednewborn.com

Also - take a look at this page - it is written by Margaret STorment, OT who was the lead OT at Texas Children's Hospital. It is called Guidelines For Therapists - this may be helpful for you at this time.

http://ubpn.org/awareness/A2001Rstorment.html

Also - if you have some time you may wasnt to peruse the rest of the documents we now have on-line in the Awareness Section

ubpn.org/awareness

regards to you and the family you are working with,
francine

www.injurednewborn.com

Francine, Thank you so much for your rapid reply. I have Margaret Storment's info and find it quite helpful. I will see this little girl tomorrow and may have some further questions if that's OK.


Thanks again, and I'll be in touch.

Angie - just so you know this....dont' know what version of Margaret's stuff you had.... but the one on the awareness area is the LATEST information - she updated it just for us.
-francine

Also.... I always remember things later....

On Maia's site, I have the TCH protocols for post mod quad therapy for under 2 years old...just in case you don't have that.

www.injurednewborn.com/maia/homepage.html

it's in the mod quad section.

Take care,
francine

Angie,

My son also was uncomfortable (mostly unsure, I think he felt abandoned without the cast!) for a little bit after removing the cast, but it didn't last long. He treated his arm gingerly for about four or five days, then no problem at all. Like Francine, I recommend the warm baths, it was very soothing for him.

Thank you for taking the extra step and time to research and reach out on behalf of the child you are treating. You are obviously the type of therapist who goes the extra mile for their patients, and your level of care is really appreciated by all of us in this community! Most of us have struggled at times with finding the right therapist willing to take the time to learn about this injury and treatment protocols, I'm sure we are all jealous of the family who lucked out with you!!

Blessings,
Bridget

my little girl 3 yrs old would hold her arm up on top of her head for a while each time we removed the splint, it took about aweek to get used to it coming off.