A minerva jacket cast is used to immobilise the various levels of the cervical and thoracic spine. A minerva cast is generally made of fibreglass casting material and remains in place for approximately four to 12 weeks. The cast can only be removed by a cast technician or orthopaedic doctor.
When will a minerva cast be used?
Minerva casts can be used for patients who have:
- musculoskeletal disorders
- suffered spinal injuries including fractures or ligamentous damage
- recently undergone spinal surgery.
What the cast will feel like
- At first, the minerva cast will feel awkward and uncomfortable but your child will soon adapt and learn how to make themselves comfortable.
- It should be possible to talk, swallow and breathe without discomfort. It is normal to feel some force underneath the chin — this pressure is necessary to immobilise the neck.
- Avoid pulling the chin down — this will increase pressure and may make the immobilisation of the neck less effective.
- Discourage your child from pulling their chin down behind the chin piece — this will change the spinal alignment and may cause further damage.
- Encourage your child to stays as active as possible while wearing the cast.
- Avoid heavy lifting, running and any activity involving significant physical contact.
- Discuss the amount and type of activity with your orthopaedic specialist before returning to these activities.
- If at any time during activity your child experiences aching or pain in the neck, ensure they stop and rest.
Eating and drinking
- It can be difficult to open your mouth fully in a minerva cast. This can make eating a challenge. Cutting meals into small pieces can help by making chewing easier.
- Eat five small meals a day rather than three large meals.
- Drink fluids through a straw. Regular and small intake of fluids is better than one large amount. This will help to keep bowel motions regular and reduce the risk of spilling fluids on the cast.
- Sleeping can be difficult until your child finds a comfortable resting position.
- They may sleep on their back or side.
- A small pillow or folded towel may be used to support their shoulders. Make sure this is no thicker than 5 cm.
Bathing and hygiene
- Keep the minerva cast dry at all times.
- This means normal showers are not an option.
Use sponge bathing to keep your child as clean as possible.
- To clean chest: Lay your child flat on their back— using correct spinal precautions—and gently clean their chest with a damp towel. This can be done through the abdomen hole. Dry the skin thoroughly.
- To clean legs: Using a sponge, wash in a shallow bath (with water below cast level) or use a hand- held shower head, covering the bottom of cast with plastic bag to keep it dry.
- Do not use soaps, lotions or powders in and under the cast.
- Use spray deodorant, not roll-on. Roll-on can soil the cast and is difficult to fully remove. If it builds up, this can cause skin irritation.
Keeping the skin in good condition
- Keep the Minerva cast as clean and dry as possible
- Use a torch to check skin under the cast at least once a day to make sure there are no signs of skin breakdown such as ‘bruise-like’ or red discolouration. If you notice any changes in the skin’s appearance, contact us for review.
- Check skin for signs of pressure sores, especially around the chin.
- Do not let your child place objects down, up or inside the cast.
Your child must return for regular reviews to ensure that cast continues to fit correctly. Significant changes in growth, weight or swelling may require modification of the cast. Contact us for review as required.
When to get help
Contact us immediately if you notice:
- a bad smell coming from underneath cast
- skin shows signs of breakdown ( ‘bruise-like’ or red discolouration)
- any other problems with the cast.
- your child is experiencing a significant increase in pain
- sensation in your child’s limbs change
- strength of your child’s limbs change.
Remember — you must not remove or modify your child’s cast on your own. If problems arise, contact us as soon as possible and ask for urgent review.
Orthopaedic Outpatients Department
Level 1, Queensland Children’s Hospital
501 Stanley Street, South Brisbane
t: 07 3068 2579
t: 07 3068 1111 (general enquiries)
In an emergency, always call 000.
If it’s not an emergency but you have any concerns, contact 13 Health (13 43 2584). Qualified staff will give you advice on who to talk to and how quickly you should do it. You can phone 24 hours a day, seven days a week.