Hip Spica Cast

What is a hip spica cast?

A hip spica cast is also called a body cast. The cast is a hard splint that completely encloses your child’s hips and legs in the best position for healing. It prevents the hips and femurs (thigh bones) from moving. The spica cast can be made out of plaster or fiberglass. A bar often attaches the legs of the cast to keep them in place.

When is it used?

Most often, a hip spica cast is used to correct hip problems in infants. The cast may also be used if your child has a broken thigh bone.

A hip spica cast starts at the chest and usually goes all the way down one or both legs. A cast may stop at the knee if the problem is a broken bone. Your healthcare provider will decide which type of spica cast will work best for your child.

How can I take care of my child?

Children often need to be in spica casts for 8 weeks or longer. Sometimes the cast may be changed by a healthcare provider. Taking a child out of a spica before the bones of the leg or hip are healed may disrupt the healing process. Replacing a spica cast may not be possible. It is very, very important to keep the cast dry.

Keep the cast dry

• The spica is open around the genitals and buttocks. Urine or moisture can get the cast wet. Change diapers frequently to help to protect the cast. It may help to use two diapers: one under the cast, and a larger one on top of the cast. You still need to change the diaper before the spica cast gets wet. If a spica gets wet or soiled, it may soften, crack, or get so dirty that it needs to be replaced. If urine or stool get on the cast, clean it with a slightly damp cloth.
• Your provider will probably tell you not to give your baby a bath. Instead, you can use a sponge and cloth to wash your baby. You can wash your baby’s hair with the baby on a soft pad on the kitchen counter.

Check your child’s skin

• Watch to see that the spica cast does not get too tight and rub against the skin. Make sure your child’s toes are pink and warm.
• If itching is a problem, try using a hair dryer on the cool setting to blow air over the itchy skin.
• Do not use lotion or powder inside the cast or on the skin at the edges of the cast. Powder can cake, and lotion can make the skin more likely to develop sores.
• If your child is in one position too long, irritation, redness, or pressure sores can develop. Re-position your child frequently to avoid these problems. If an area is uncomfortable, position your child so that there is less weight on that area.
• You can gently use the bar between the legs and another part of the spica to re-position your child. Never use the bar by itself to lift or turn your child.

Keep your child comfortable

• Children in a spica cast usually prefer to be dressed. This helps them to feel more normal. The cast is bulky, so you may need to get larger size clothing. Velcro fasteners can help children in a spica cast get dressed more easily.
• To help your child have a bowel movement, make sure your child’s head is slightly higher than the rest of the body. This helps your child bear down to pass stool. Watch your child’s diet so that he or she does not get constipated. Also be careful about giving your child new foods that may cause diarrhea.
• When your child needs to ride in a car, you need to have the proper car safety seat. Sometimes your child’s own car seat can be used. Sometimes you need to rent a special car safety seat. Bring your child’s car seat in to the healthcare provider to see if your child can use it with the spica cast.

When should I call my child's healthcare provider?

Call your child’s healthcare provider if:

• The cast softens, cracks, breaks, gets very dirty, or starts to smell.
• Your child has red, swollen or tender skin near or underneath the cast
• Your child’s toes are cool or cold, look blue, or start to swell
• Your child develops an unexplained fever, especially if your child also has a painful area under or around the cast