What is a hip spica cast?
A hip spica cast is a special type of cast that helps keep the hip joint in place following surgery for developmental dysplasia of the hip (DDH).
Caring for your child while in the cast
Keeping the cast clean and dry
To keep the padding dry, line the edges of the hole near the groin, with "petals" of water-proof tape. Each piece of tape should overlap the other just like the petals of a flower. Make sure that each piece of the tape covers at least two to three inches of the padding inside the cast. The nurse or the orthopaedic technician can show you how to do this before your child leaves the hospital.
Your child may have a sponge bath. Be careful not to get the cast wet. If the cast does get wet, you may clean the soiled area of the cast with a damp cloth. You should use a hair dryer on a cool or cold setting to dry the cast.
Changing your child's diaper or toileting
If your child is very small, you should tuck a smaller size disposable diaper into the front and back of the cast and a larger size diaper should be worn over the cast. Change the diaper as often as every four hours or as soon as the diaper is soiled so that the cast does not get soaked with urine or stool. This could make the cast have a bad smell and may also cause harm to your child's skin.
If your child is toilet trained, make sure the back of the cast is protected with a plastic wrap that is tucked in well. This is especially important for a girl when she is using a bedpan so that the urine does not spill into the back of the cast. Boys can use a urinal. You can elevate your child's head and shoulder when they are on the bed pan. This will prevent the urine from going backward into the cast. At night, you can check or change the diaper with position changes.
Protecting the cast from damage
Make sure your child does not walk, kneel or stand while in the cast unless the doctor says it is fine to do so. Do not push or pull the leg that is in the cast as it might crack or break the cast or cause pain or injury to the affected leg. Make sure your child does not put any small objects or toys inside the cast. Try to avoid food or crumbs from getting into the cast as well. Do not use any sharp objects, like knitting needles or combs, to scratch the skin if your child feels itchy. This may cause pressure, skin irritation, and damage. If your child feels itchy often, contact your doctor.
Protecting your child’s skin
Turn your child every four to six hours during the night. You may turn them from side to side or from stomach to back. Ask your child to extend their arms above the head, which will make the turn easier. Make sure the toes or heels are not pressing against the bed or rubbing on the sheets as it may cause skin break down or blisters. You can turn your child more often if you notice any redness or skin break down. When you turn your child, you can massage the skin as well. Do not use any talcum or baby powder inside the cast.
Making sure the cast is not too tight
Check the colour of the affected limb. You can use the other limb to compare. Toes and feet should be pink and warm to touch. If your child can understand you, make sure that they are able to feel when touched. Ask your child to move their toes and feet four to five times a day. If your child is too small to understand, just tickle your child's feet and check for movement.
Check the cast more than once a day for any bad smells and re-petal the cast if needed. If you find any consistent changes in the colour, feeling and movement of your child's limbs or if you have any other concerns, contact your doctor.
Diet
If your child is taking narcotic pain medication for too long, it may cause some constipation. Since your child is not moving around as much as before, this can also cause constipation. To prevent constipation, give your child a diet which is high in fibre and plenty of fluids.
