cast discoloration

[Jmom2boys]

Hi.  My 5 yr old son had surgery (tibial tendon transfer, posterior medial release, and calcaneal osteotomy) 2 weeks ago.  He had a cast change in the OR 4 days ago and has been walking and running well.  I noticed tonight that the bottom of the cast/foot seems to have a small damp spot with a very slight discoloration or darkening.  There is no odor or pain.

Is this normal?  Or should I get him in for a cast change?

[JainMD]

Hi,
If the color change is on the cast then there would be some bleeding inside. Once you open the cast, then we would find where the bleeding coming from or is it just that stitches have open up a bit.
I recommend you take him as early as possible and get the matter sorted out.
Keep me informed I would be interested to know the progress.
Bye.

[Jmom2boys]

Thank you for your quick reply.  I am going to take him into the Orthopedic room at our local children's hospital this morning.
This morning the bottom of the cast is dry but he has not been on it all night.  I am concerned that there is some bleeding or oozing of something that is collecting at the bottom of the cast during the day.
The color change is on the cast and is just a darker spot, possibly red or brownish which makes me suspect blood.
I will let you know how it goes.

Thanks again.

[JainMD]

Hi,
I think he is having some compressive pathology due to cast on.
Does the color change is red to bluish? If yes, there might be vascular compromise.
I think you need to visit Emergency room or Orthopedic room as early as possible and get it seen by doctor early.
You should also ask for cast to be removed and put another cast if required.
Keep me informed if you have any queries.
I would be interested to know about the progress.
Bye.