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Hip Spica Cast Care in Children
WHAT YOU NEED TO KNOW:
A hip spica cast is also called a body cast. It is used to prevent hip and leg movement after surgery or broken a bone. Most spica casts will not allow your child to stand, walk, or bear any weight. The cast will have an opening so he can urinate and have bowel movements.
Follow up with your child's healthcare provider as directed:
Your child will need to return to have his cast removed and his bones checked. Write down your questions so you remember to ask them during your visits.
Care for your child's cast while it hardens:
Your child's cast may need up to 48 hours to dry and harden completely.
- Protect the cast: Do not let your child put weight on his cast. Do not bend, lean on, or hit the cast with anything. Use the palms of your hands when you move the cast. Do not use your fingers, because this can create indentations on the cast as it dries.
- Change positions often: Change your child's position every 2 hours to help the cast dry faster. You may let him lean on his side from time to time.
- Keep the cast dry: Tie plastic trash bags around your child's cast to keep it dry while you bathe him. Use a blow dryer on cool or the lowest heat setting to dry his cast if it gets wet. Do not use a high heat setting, because you can burn your child's skin. Certain casts can get wet. Ask if your child has a waterproof cast.
Care for your child's cast after it hardens:
- Check the cast every day: Contact your child's healthcare provider if you notice cracks, dents, holes, or flaking on your child's cast.
- Keep the cast clean and dry: Cover the cast with a towel or bib when your child eats. He may have a small piece of cast that can be removed to check incisions under his cast. Make sure the small piece of cast is kept tightly closed. If the cast gets dirty, use a mild detergent and a damp washcloth to wipe off the outside. Continue to cover the cast with trash bags to keep it dry while you bathe your child.
- Care for the edges of your child's cast: Cover the cast edges to keep them smooth. Use 4 inch pieces of waterproof tape. Place one end of the tape under the inside edge of the cast and fold it over to the outside surface. Overlap tape strips until the edges are completely covered. Line the genital or diaper area opening completely. Change the tape as directed. Do not pull or repair any of the padding from inside the cast. This could cause blisters and sores on the skin under your child's cast.
- Keep weight off the cast: Do not let anyone push down or lean on your child's cast. This may cause it to break.
- Do not use sharp objects: Do not let your child use a sharp or pointed object to scratch under his cast. This may cause wounds that can get infected, or the item may be lost inside the cast. If his skin itches, blow cool air under the cast. You may also gently scratch his skin outside the cast with a cloth.
Keep your child comfortable:
Keep your child's head and upper body in a semi-sitting position at all times. Do this by propping his head, shoulders, and back up on pillows.
Help your child with his toilet needs:
- Place a disposable diaper inside the edges of the rear part of the cast. Keep the 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.
- Gently turn your child to one side and place the bedpan under his buttocks. Turn him 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. Remove and throw away the plastic wrap as soon as your child is finished.
- Wash and dry his buttocks after he uses the bedpan.
- Carefully lift your child onto and off of 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 after he uses the toilet.
How to move your child safely:
- Lifting: Carry your child as close to you as possible. When you lift your child by yourself, cradle him under the arms and the buttocks, supporting the weight of the cast. When 2 people are lifting, one person lifts under the shoulders while the other lifts the legs.
- Lounge chair: An outdoor lounge chair may also be used as a portable bed. Use pillows and towels for support and to cover any rough edges.
- Special car seats: Ask your child's healthcare provider how to get a car seat made for children in spica casts. Your child will be in a lying position in the car seat. Always have him ride in the back seat of the car.
- Stroller: To move around at home, small children may fit into a stroller or wagon padded with pillows.
- 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 child's healthcare provider how you can get one.
Contact your child's healthcare provider if:
- Your child has a fever.
- Something falls into your child's cast and gets stuck.
- You see drainage, or your child's cast is stained or smells bad.
- Your child has redness, blisters, wounds, or itching inside the cast that will not stop.
- Your child is crying and is unusually fussy.
- You have questions or concerns about your child's condition or care.
Seek care immediately if:
- Your child has more swelling than he did before the cast was put on.
- Your child has severe pain that is getting worse and does not go away after he takes pain medicine.
- Your child's cast breaks or gets damaged.
- Your child's toes are swollen or the cast becomes too tight around his chest.
- Your child's skin turns blue or pale.
- Your child's skin tingles, burns, or is cold or numb.
- Your child has trouble breathing and chest pain.
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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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