Hip Dysplasia: Caring for Your Child in a Body (Spica) Cast

Tools & Resources

• Whooping Cough Risks
• Are Germs Good for Kids?
• Enterovirus D68: Get the Facts
• Taming Toddler Tantrums
• What Is Dry Drowning?
• Kids and Concussions

Step 1 of 6


Action Set

Hip Dysplasia: Caring for Your Child in a Body (Spica) Cast

Spica casts, also called body casts, are frequently used to treat children who have hip, pelvis, or leg problems, such as developmental dysplasia of the hips (DDH). You may be nervous about having a child in a spica cast. It can be overwhelming to be responsible for the care and cleaning of the cast. But caring for a spica cast is not as hard as it may at first seem. After you get into a routine, you'll find that you can handle the daily tasks involved in cast care. You will become more and more confident that you can keep your child safe and comfortable while he or she is in the cast.

You can help care for your child's spica cast by:

• Learning basic cast-cleaning techniques.
• Learning how to manage daily care issues, such as changing a diaper.
• Gaining confidence in handling your child and knowing how to identify problems that can develop.

 How do you care for your child's spica cast?

Up Next in This Action Set:

How do you care for your child's spica cast?

Step 4 of 6


Action Set

Properly caring for your child's cast includes allowing it to dry properly, keeping it clean, preventing infections and other problems, and knowing when to call the doctor. You should also be able to position your child properly in the cast.

Drying the cast

If your child's cast is made of plaster, it may need time to dry after it is first put on. Your child will likely be in a semi-sitting position and may need you to help him or her move. Turn your child at least every 2 hours for the first 24 to 48 hours to prevent uneven drying of the cast. You can use a fan to help the cast dry more quickly, but don't use heat. When you tap the cast and hear a hollow sound, it is dry.

Keeping the cast clean and dry

Spot-clean the cast, and do your best to keep it dry. But realize that the cast may get dirty or wet now and then.

Focus on taking preventive measures and cleaning the cast when needed.

• If your child wears diapers, use a smallersize than you normally would and use only disposable diapers. Cut the adhesivetabs off the diaper so that they won't irritate your child's skin, and tuck thediaper inside the cast beginning at the child's rear and moving toward thefront. The plastic side of the diaper should face the cast. The absorbent sideof the diaper should be next to your child's skin. Change the diaper as soon aspossible after your child urinates or has a bowel movement. At night, add anextra smaller diaper, sanitary napkin, or adult incontinence pad inside thediaper.
• If you can lift your potty-trained child, help him or heruse the toilet. Try tucking a sheet of plastic food wrap under the back edgesof the cast to help guide your child's waste into the toilet. Remove theplastic and throw it away each time after your child has finished using thetoilet. (Do not flush plastic wrap down the toilet.) Be sure the skin is cleanand dry after your child uses the toilet.
• Use a bedpan for a biggerchild. Put your child in a semi-sitting position, in which thetorso and head are up higher than the lower body.Gently turn your child onto one side and slip the bedpan beneath his or herbottom. After you return him or her to the semi-sitting position, adjust thebedpan as needed by locating it between your child's thighs. Make a "wick" fromtoilet paper for girls when they urinate. Roll some sheets of toilet paper andplace them between the genital area and bedpan. This helps the urine flow intothe bedpan in a controlled stream. Be sure the skin is clean and dry after yourchild uses the bedpan.
• Clean off heavily soiled areas of the castand reduce odors. You can use a damp cloth, with or without cleanser, to wipedirty areas on a fiberglass cast. Scrubbing toothpaste onto soiled areas canalso help to get rid of odors. Use a cloth with as little water as possible toclean a plaster cast. Odor strips, such as those used in the shoes, can betaped onto the outside of the cast.
• If the cast gets wet, dry itby using a hair dryer on a low, cool setting. Keep the hair dryer about18 in. (46 cm) away from yourchild's skin.
• Give your child a daily sponge bath. Take care not toget the cast wet. Use a damp cloth, and clean your child's exposed skin andalso under the edges of the cast. Remove small crumbs or other particles fromunder the cast if you can do so easily. Do not poke under the cast with anyobjects to try to get anything out of the cast.
• Place your child'sclothing over the cast to prevent food or small toys from getting insideit.

Positioning, movement, and comfort

Keep your child safe and comfortable by using basic care techniques.

• You can applymoleskin padding to the edges of the cut-out open areaaround your child's genitals and bottom if these hard edges irritate or hurtyour child's skin. Cut 4-inch pieces of moleskin. Place one end of a pieceunder the inside edge of the cast. Wrap the other end up onto the cast and tapeit in place. No tape should be touching your child's skin. Partially overlapthe pieces until you have made a soft, padded edge all around the openings ofthe cast.
• Check for swelling. Your child's toesshould be pink and warm (not hot). He or she should be able to wiggle them andfeel them being touched.
• Watch for signs of skin irritation. Lookat your child's skin around the edges of the cast every day. Use a flashlightto look under the edges of the cast.
• Change your child's position every 2 to 4hours. Regular movement helps to relieve pressure areas under the cast to helpprevent irritation and sores. Now and then, put your child in a semi-sittingposition by propping his or her head on pillows or using a beanbag chair.
• Never move or lift your child using thecrossbar of the cast. This type of movement can harm the cast or disturb yourchild's hip placement.
• Preventpressure sores by keeping your child's feet off flatsurfaces, such as the floor or bed mattress, for long periods. Place a pillow,rolled-up towel, or other soft object:
  • Under the top front of the ankles while your child is lying on his or her stomach.
  • Beneath the ankles and under the calf of the leg while your child is lying on his or her back.
• Provide comfortable clothing. Your child canwear oversized shirts, skirts, and dresses over the cast after it is dry. Youcan adapt clothing that goes over the legs and torso, such as shorts or pants,by cutting the side seams. You can then apply snaps or stick-on strips, such asVelcro, to the seams. The sides can be attached to each other or to the sidesof the cast.
• Move your child with care. Bend your knees and keep your backstraight when lifting your child. As you lift, support the weight of the castwith one arm cradled around your child's shoulders and the other around his orher buttocks. When two people move your child, one person lifts under theshoulders, the other lifts under the legs. Lift together on the count ofthree.

Your child needs physical contact with you, especially while he or she is in a cast. As long as you make sure to take basic safety measures, you can and should continue to hold, interact with, and provide stimulating activities for your child.

Encourage your child's involvement with your family.

• Move your child around to different areas ofthe house throughout the day. Try padding a wagon or stroller with pillows andblankets to move your child around the house. Older children can use awheelchair with an adjustable back, which you can rent from a medical supplystore or hospital. You may want to place your child in a reclining lawn chair in different rooms in your home or in the yard.
• Go for walks with yourchild. Many strollers are made with adjustable backs to recline as needed. Makesure your child is secured with safety belts or straps.
• Go for carrides. Your young child should always stay in the back seat and in a car seat.Depending on your child's leg positions, he or she may need a speciallydesigned car seat. Ask your doctor about where to buy or rent one. Usually theyare available through hospitals or medical supply stores. Older children mayneed to be positioned and safely secured lying down in the back seat.

Knowing when to call the doctor

Keep a constant watch on your child and the condition of the cast. Although you should call your doctor any time you have questions, talk to him or her right away whenever your child:

• Shows signs of pain or discomfort, such ascrying or fussing for unknown reasons. An older child may complain of pain orburning in a certain area under the cast.
• Has cold toes that are pale or blue.
• Is vomiting or has afever.
• Itches continuously or hasother signs of irritation, such as redness, itching, blistering, or sores.
• Has oozing from underneath thecast.
• Develops swelling.

Also call your doctor any time the cast:

• Has anything fall into it that becomesstuck.
• Develops a bad smell.
• Seems tight or loose.
• Has worn, cracked, soft,or loose spots.

Return to Hip Dysplasia: Caring for Your Child in a Body (Spica) Cast

Up Next in This Action Set:



Step 6 of 6


Action Set

See More Popular Action Sets

ByHealthwise Staff
Primary Medical ReviewerJohn Pope, MD - Pediatrics
Specialist Medical ReviewerSusan C. Kim, MD - Pediatrics