Consumer Information

Hip Spica Cast Care In Children

GENERAL INFORMATION:

What is a hip spica cast? A hip spica cast, also called spica cast or body cast, is a shaped piece of plaster or fiberglass. It may be used if your child has a broken bone in his pelvis, hip, or thigh. It is put on your child to keep his hips and legs from moving. This is done so that bones or tendons can heal correctly after an injury or surgery. The spica cast is usually put on in surgery while your child is sleeping. Most spica casts will not allow your child to stand, walk, or bear any weight.

What type of hip spica cast does my child need? There are several types of hip spica casts. One starts at the chest and goes down to one or both of your child's legs and toes. Another is applied from the chest to the foot on one leg and to the knee of the other. A spica cast that covers the chest down to the thighs or knees may also be placed. A rod may be placed between both legs to keep the hips and legs from moving. Your child's caregiver will choose which type is best for your child.

What are the risks of wearing a hip spica cast? Your child may have any of the following:

Allergic reaction: Your child may have an allergic reaction to the cast and his skin may be itchy, swollen, and red.
Burns: There is heat produced while the cast is hardening. Your child's skin may have burns and he may have pain and redness.
Compartment syndrome: Compartment syndrome is a condition when the blood flow in your child's leg or thigh is blocked by swelling. When there is swelling, your child's cast may feel very tight because there is not enough room inside it. He may have severe pain, weakness, or numbness in his leg. He may have this condition if the pain does not go away even after using pain medicine, raising the leg, or putting ice on it.
Infection: Your child may get an infection if the spica cast is not kept clean. He may also get an infection if wounds and sores are not cared for correctly. There may be pain, redness, and swelling, and you child may also have a fever.
Joint stiffness: Your child's joints may become stiff. He may have trouble moving after being kept still for a long time. Your caregiver may help your child with exercises to improve his movement.
Muscle atrophy: This is a condition where your child's muscles get smaller after not being used for a long time. Ask your caregiver about ways to strengthen and increase the size of your child's muscles.
Skin sores: Your child may have blisters, sores, or wounds if the spica cast is too tight. He may also have wounds if the skin under the cast is scratched, or if he stays in one position for too long.

What problems should I watch out for when caring for my child? Check on your child often and watch for these problems. If you see any of them, get help from caregivers as soon as possible. Watch out for the following:

Changes in skin appearance: Your child's skin should have a pinkish color and feel warm to touch. Check for sores, blisters, or breaks on the skin around the edges of the spica cast.
Changes in skin sensation (feeling): Ask your child if he feels pain, itchiness, numbness, or burning. Ask if there is less feeling in his legs, or if he feels his legs are weak.
Decreased urination and bowel movements: Check if your child is urinating regularly and having bowel movements every day. Call your caregiver if he is not having regular bowel movements, is unable to urinate, or is having other problems.
Infection: You may smell a strange odor, or see stains or discharge coming from the cast. Your child may also have a fever and increased pain in some areas.
Swelling: There should be very little or no swelling of your child's legs or feet. Make sure there is an even amount of space between your child's skin and the openings of the cast. Ask your child if his cast feels tighter than usual.

How might my child feel while he is in a hip spica cast? Your child will need to depend on someone for most of his care while he is in a hip spica cast. He may get bored because he may be missing school or his friends. He may feel sad because of how he looks, and because he misses activities while in the cast. He may also feel sad because he is not able to do the things he usually can, such as riding a bike.

What can my child do while in a hip spica cast? To decrease your child's boredom and keep him active, he may do the following:

He may exercise by himself or together with his family or friends. Your child's caregiver may teach special exercises that he can do while in the cast. You may help him exercise by moving his legs and feet. Ask your caregiver which exercises are best for your child.
He may read books, play board or video games, listen to music, or watch TV. He may do this with his family or friends.
He should try to do as much as he can for himself, such as feeding and cleaning himself up. He may also clean the spica cast by himself. Ask him to tell you about any changes he sees or feels while he is in a spica cast. Doing things for himself will help him feel better and may also keep him from getting bored.
If he is already going to school, he may study from home while in a spica cast. Call your child's teachers to give them time to plan for home study and other activities as soon as possible.

How do I care for the hip spica cast while it hardens? Your child's hip spica cast may take up to 48 hours to dry and harden completely. It needs to harden completely to be very strong and hold your child's hips and legs steady. You may do any of the following:

Do not bend it, lean on it, or hit it with anything until it completely hardens.
When moving your child, use the palms of your hands to hold the spica cast. Your fingertips may leave little dimples on the spica cast if it is not hard enough.
Change your child's position every two hours to help the cast dry faster. You may let him lean on his side from time to time.

How do I protect the hip spica cast from damage? To prevent damage to the hip spica cast you may do any of the following:

Check for any cracks, dents, dimples, holes, or flaking areas on the cast every day.
Do not break off rough edges or trim the cast. Ask your caregiver if you think this needs to be done.
Do not let your child push down or lean on any part of the cast because it may break.
Make sure that the cast is kept clean and dry.

How do I keep the hip spica cast clean and dry? It is important to keep the hip spica cast clean and dry to prevent it from getting soft and weak. It may be unable to hold your child's hips or legs steady if it breaks or goes out of shape. If this happens, your child's hips or legs may not heal very well. You may do any of the following:

Cover the cast with a towel, large T-shirt, or bib when your child is eating. This will help prevent food and drinks from spilling on or into the cast.
Protect the cast with towels or plastic trash bags during your child's bath. Wash all of his skin not covered by the cast with soap and water every day. Some types of casts are able to get wet or even soak in water. Ask your caregiver for more information about these casts.
You may use a hair dryer set on the lowest heat setting to dry a cast that gets wet. This may dry the spica cast faster than just letting it dry by itself. Make sure that the hair dryer is not blowing air that is too hot or you may burn your child.
You may use a mild detergent and a washcloth to wipe dirt and grime off the spica cast.

How do I care for the edges of the hip spica cast? You or your child's caregiver may fix the cast edges to keep them smooth. This prevents your child from scraping against any rough edges of openings on the cast. You may do the following:

Cut pieces of waterproof tape about four inches long.
Place one end of the tape under the inside edge of the cast and wrap it onto the cast's outside surface.
Overlap the tape strips until the edges of an opening on the cast are completely covered.
Cover the genital or diaper area opening completely. Your child may have skin problems, and the cast may smell badly if this area is not completely waterproofed with tape.
Do not pull or rearrange any of the padding inside the cast. This could cause blisters and wounds to your child.

What is windowing? Windowing is when your child's caregiver cuts away a small piece from the cast. Your child's caregiver uses this opening to check and care for incisions (cuts) from surgery, or other wounds. The piece that was cut out looks like a small window and can be placed back to close the opening. The piece is taped securely in place. This will keep dirt from going through the cracks at the sides of the opening. Closing the window tightly will also prevent the skin under it from swelling.

CARE AGREEMENT:

You have the right to help plan your child's care. To help with this plan, you must learn about your child's health condition and how it may be treated. You can then discuss treatment options with your child's caregivers. Work with them to decide what care may be used to treat your child.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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