Your child has been fitted with a special cast. Please follow the instructions below for the best way to care for your child at home.
What is a Hip Spica Cast
A hip spica is a special type of cast used to immobilise the hip joints and/or the thigh. This cast is used to promote healing of a damaged hip joint or a fracture/break to the femur (thigh bone).
The hip spica cast will vary depending on the intended use of the cast; usually the cast extends from below the chest down to below the knee. If the problem is on the hips or thighs then the cast will extend past both knees, if the problem or injury is on one side only the cast will be below the knee on the affected side.
A hole is left in the groin area of the cast to allow the child to toilet or for nappies to be changed.
The purpose of the hip spica cast is to keep the affected hip/thigh in the best position, the shape of the hip spica varies; they are made from Delta Cast material which is a light weight casting tape.
Taking your Child to the Toilet in a Hip Spica Cast
There will be a ‘letterbox’ opening for hygiene in the plaster.
The best method we have found is to cut out the pad of a nappy or use a large sanitary towel and tuck this into the opening within the letterbox opening and then use a larger size nappy over the top and around the outside of the plaster. It is important that you try to keep the skin clean and as dry as possible.
We suggest you check your child’s nappy more frequently to reduce the risk of getting sore or soiling the cast. For further information visit hipdysplasia.org
How Can I Position my Child in a Hip Spica Cast
It is important that your child is positioned to avoid discomfort and pressure areas.
A pillow underneath the legs is recommended leaving heels free so as not to cause friction.
Regular checks of the heels is a must to reduce any risk of pressure sores.
Beanbags are the most comfortable seating for the child as you can change position, keeping heels free.
A wheelchair where the backrest can go back is recommended as the child will not be able to sit upright.
Most children are able to fit into their buggies as they can recline.
Washing
It is impossible to bath your child while they are in a hip spica cast.
A top and tail wash is recommended at least once a day making sure all areas are dry.
Do not put cream or powder under the cast edges as this can cause sores.
Check nappy and heel areas on a regular basis.
Dry skin can be noted around the edge of the cast which is normal.
Sleeping
There is not a great deal of choice about the position your child sleeps in.
It is very important to relieve the pressure of the heels while sleeping to reduce the risk of friction.
A rolled up towel can be used to keep the heels off the bed sheets.
If your child is in nappies you can raise the head end of the cot to help the urine run down into the nappy and not up the back.
Circulation Checks
| What to check for | What is normal |
|---|---|
| Colour of toes | Pink and warm |
| Sensation in toes | Able to feel all toes being touched on all sides |
| Toe swelling | No swelling |
| Toe wiggle | Able to wiggle all toes |
Skin Inspection
Problem
Pressure sores
What to look out for
Plaster can rub against skin once padding has compressed; particular areas are around the ankle and the back.
What to do
Let your Orthopaedic Practitioner know as soon as you notice any changes. They will discuss this with you and you will need to arrange to bring your child in so that the Orthopaedic Practitioner can check the hip spica cast and possibly trim and pad out affected areas.
Problem
Escaped urine and faeces under the plaster (using a barrier cream can minimise this)
What to look out for
Over time a build up of escaped urine and faeces can begin to cause a skin breakdown.
Signs of a skin breakdown include:
- Red sores
- Nappy rash
- Child becoming increasingly grizzly or having problems sleeping
What to do
Use adhesive padding which will be given to you on edges and this can be changed.
Let your Orthopaedic Practitioner /Consultant know about any changes as soon as you notice them. Will need to bring your child in so the Orthopaedic Practitioner can re-assess.
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