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Hip Spica Cast Care in Children
WHAT YOU SHOULD KNOW:
- A hip spica cast, also called spica cast or body cast, is a shaped piece of plaster or fiberglass. It is used to keep your child's hips and legs steady so that bones or tendons can heal correctly. It is used after hip surgery, or to line up broken bones after an accident or injury. There are different types of spica casts, which may cover your child's chest down to his toes. Your child may have to wear a spica cast for several weeks and depend on other people for his care. This may be hard at first, but your caregiver will teach you ways to make caring for your child easier.
- Your child may have some problems if he or the spica cast is not cared for correctly. The cast may be itchy and cause skin swelling, and redness. He may have burning, blisters, sores, infection, or stiff and painful joints. Your child may feel lonely and bored because he is missing school and his friends. He may also feel sad for himself because he is not able to do the things that he can usually do. Follow your caregiver's instructions carefully and ask your caregiver questions about your child's care or condition. You and your family may work together with your child to help him heal faster, and better cope with having a hip spica cast.
Keep a current list of your child's medicines:
Include the amounts, and when, how, and why they are taken. Bring the list and the medicines in their containers to follow-up visits. Carry your child's medicine list with you in case of an emergency. Throw away old medicine lists. Give vitamins, herbs, or food supplements only as directed.
Give your child's medicine as directed:
Call your child's primary healthcare provider if you think the medicine is not working as expected. Tell him if your child is allergic to any medicine. Ask before you change or stop giving your child his medicines.
Ask for more information about where and when to take your child for follow-up visits:
For continuing care, treatments, or home services for your child, ask for information.
Your child's caregiver checks if the bones are healing well and if there are other problems. Your child may need x-rays to check how his bones are healing.
Keeping your child active:
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.
Keeping your child comfortable:
- If your child complains of itchiness, you may blow cool air under the cast. You may also gently stroke the nearby skin with a piece of cotton or cloth. Do not let your child use a sharp or pointed object to scratch the skin under the cast. This may cause wounds that can get infected.
- Keep your child's head and upper body in a semi-sitting position at all times. Do this by propping your child's head, shoulders, and back up on pillows.
- Place small pillows or a rolled towel under his legs to keep his heels and feet off flat surfaces. Do not let your child's feet and heels rest directly on the mattress. This may cause pressure sores. Pressure sores are bruised areas that can be painful and lead to other problems.
- Turn your child from front to back or side to side every 2 to 4 hours during the day. Do this as often as you can during the night. You may use pillows to keep your child comfortable.
- You may use a beanbag chair to help position and prop your child comfortably.
- You may raise his legs to decrease any swelling.
Helping your child with his toilet needs:
There is an opening in the genital (crotch) or diaper area in your child's cast so he can urinate and have bowel movements. You may do the following:
- Using a bedpan:
- Gently turn your child to one side and place the bedpan under his buttocks. Turn his back again and he will be over the bedpan. Check between your child's thighs to make sure the bedpan is in the right place.
- A long sheet of plastic food wrap may be placed under the rear edges of the cast and hung into the bedpan. This will help guide urine or bowel movements and keep the cast and bed dry.
- Wash and dry his buttocks after using the bedpan to prevent skin rash.
- Using a diaper:
- Place a disposable diaper inside the edges of the rear part of the cast. Keep the plastic side facing the cast, and absorbent cloth side next to your child's skin.
- Change diapers as soon as your child urinates or has a bowel movement.
- Keep your child's head higher than his feet. Gravity helps keep urine and bowel movements out of the cast and in the diaper.
- Using the toilet:
- Carefully lift your child on and off the toilet.
- A long sheet of plastic food wrap may be put under the rear edges of the cast and hung into the toilet. This will help guide urine or bowel movements into the toilet. Remove and throw away the plastic wrap as soon as your child is finished.
- Wash and dry his buttocks afterwards.
Moving or traveling with your child:
Moving and traveling with your child when he still has a hip spica cast may be hard at first. Do any of the following to make moving and traveling easier:
- Lifting: Carry your child as close to you as possible. When lifting your child by yourself, cradle him under the arms and the buttocks, supporting the weight of the cast. When two people are lifting, one person lifts under the shoulders and the other lifts the leg at the same time. Talk out loud to each other so you both lift together in a smooth motion. Bend your knees and keep your back straight when lifting.
- Lounge chair: An outdoor lounge chair may also be used as a portable bed. This helps keep your child together with you in family activities. Use pillows and towels for support and to cover any rough edges.
- Special car seats: There are car seats specially made for children in spica casts. When you are driving the car, always put your child in a lying position in the back seat. Ask your caregiver how to get one for your child.
- Stroller: To move around at home, small children may fit into a stroller or wagon padded with pillows. Use a seat belt if needed to make sure your child will not be able to fall out.
- Wheelchair: Older children may be able to use a wheelchair with an adjustable back support. This allows your child to lean back and sit comfortably. Ask your caregiver how you can get one.
Protecting the hip spica cast from damage:
- 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.
Keeping 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 may be 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.
Removing the hip spica cast:
Your child's caregiver will tell you when it is time to remove the cast. To cut away the cast he may use a tool which may be noisy and scare your child. he may be afraid that the tool will touch his skin. Tell your child that this is unlikely, and that he needs to stay still while the cast is being removed. The skin under the cast may look different from other areas of skin. In time this will change and will look like the rest of your child's skin.
CONTACT A CAREGIVER IF:
- Your child has a fever.
- Something falls into the cast and gets stuck.
- You cannot make it to your child's next appointment.
- Your child has redness, blisters, wounds, or itching that will not stop inside the cast.
- Your child is crying and is unusually fussy.
- You have questions or concerns about your child's condition, care, or medicine.
- You child is having problems with urination and bowel movements.
SEEK CARE IMMEDIATELY IF:
- There is a bad smell and new stains are coming from under your child's spica cast.
- Your child has more swelling than he did before the cast was put on.
- Your child has trouble breathing and chest pain.
- Your child has very bad pain that is getting worse and does not go away.
- Your child's cast breaks or gets damaged.
- Your child's skin below the cast turns blue or white, or feels cold, numb, tingly, or has a burning feeling.
- Your child's toes are swollen or the cast becomes too tight around his chest.
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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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