How to Care for Your Child's Hip Spica Cast

1, 2, 3, lift, will make it less painful for your child.

For smaller children, using a stroller or wagon padded with pillows may be helpful. For older children, a wheelchair may be used.

Your child may find that sitting in a boppy, beanbag, or reclining chair is better. Be sure your child's head and upper body are kept raised.

Check with your doctor about having your child use crutches.

Make sure your child sits up when eating to avoid choking.

Take care of your child's skin.

Have your child change from belly to back or side to side every 2 to 4 hours during the day and at night. This will help to avoid pressure sores.
Keep your child's feet and heels from resting on flat surfaces. Put small pillows or a rolled up towel under the calves.
Check each day to make sure there is the space between your child's skin and the cast. Swelling may cause the cast to fit too tight. Check the skin along the edges of the cast for redness or sores.
Sponge bathe your child. Use plastic or cast covers to protect your child's cast and keep it dry.

Using the bathroom or diapers.

If your child wears a diaper, take a smaller diaper or thick pad and tuck it inside the opening at the bottom of the cast. Then, use a larger diaper over the outside of the cast. This is called "double diapering".
There is an opening in the cast so your child can pass urine and have bowel movements. If the cast lets your child bend at the waist and you are able to lift your child, you can put them on the toilet. Your child may also use a bedpan or a urinal.

Take care of the cast.

Keep the cast clean and dry. Wet plaster can soften and wet padding can bother your child's skin. Fiberglass casts can be dried using a hair dryer set on cool. Make sure to dry fully. If the cast gets wet and you cannot get it dry, call your doctor to see if it needs to be replaced.
Avoid hitting the cast into objects that could cause it to crack or break. Check each day for any dents or cracks.
Tell your child to never put things like pencils, rulers, or coat hangers down the cast to try to scratch if itching happens. You can use a hair dryer to blow cool air down into the cast. Talk with your doctor if itchiness does not stop.
Do not let dirt, sand, or powder get inside your child's cast.
Cover the cast when your child is eating to keep food or drinks from getting on or inside the cast.
Do not pull the cloth padding out of the cast.
Do not try to take off pieces or trim rough edges.
Do not try to take off the cast on your own. Your doctor will schedule the proper time and a special cast saw will be used.

What follow-up care is needed?

Your doctor may ask you to make visits to the office to check on your childs progress. Be sure to keep these visits.
If your child has stitches or staples, they will need to be taken out. Your doctor will often want to do this in 1 to 2 weeks.

Will physical activity be limited?

Your child will have to limit activity while wearing the cast. Activity will also be limited for a while after the cast is taken off. Talk to the doctor about the right amount of activity for your child. If your child is lying down a lot, help them change positions at least every 2 to 4 hours. ‚

What changes to diet are needed?

Talk with your doctor or dietitian about what foods are best for your child. Make sure your child drinks 6 to 8 glasses of liquids each day. Offer your child fruits, vegetables, and foods with lots of fiber and calcium. This will help to avoid hard stools, help with faster healing, and give your child more energy. ‚

What problems could happen?

Compartment syndrome ¢ ˆ ’ A serious problem that happens when pressure builds because the cast is too tight. This may cause injury to nerves, blood vessels, and tissue if not corrected.
Pressure sores
Fracture does not heal or needs a longer time to heal
Growth plate has been affected causing a limp or the leg does not keep grow
Arthritis

When do I need to call the doctor?

Signs of infection. These include a fever of 100.4 ‚ °F (38 ‚ °C) or higher, wound that will not heal.
Signs of wound infection. These include swelling, redness, warmth around the wound; too much pain when touched; yellowish, greenish, or bloody discharge; foul smell coming from the cut site; cut site opens up.
More pain or swelling than expected
Numbness or tingling meaning the cast may be putting too much pressure on your childs nerves and your child can not feel your touch
Toes are cold, toes or toenails turn white or blue, can't move the toes
Bad odor coming from the cast
Itching that does not go away
Skin near the cast edges becomes bothered
Mold or mildew builds up due to sweating or getting the cast wet
Cast becomes loose, wet, or gets damaged
An object gets stuck in the cast and you cannot get it out

Helpful tips

Limit what your child drinks at night to avoid leakage into the cast.
At bedtime, have your child lie away from the sides of the bed, or use a bed with side rails.
Have your child wear clothing that is easy to slide up and down. Try pants with snaps or you may want to cut the sides of shorts or pants and use velcro to keep them together.
Ask your doctor for exercises your child can do each day to keep arms and legs moving.

Teach Back: Helping You Understand

The Teach Back Method helps you understand the information we are giving you about your child. The idea is simple. After talking with the staff, tell them in your own words what you were just told. This helps to make sure the staff has covered each thing clearly. It also helps to explain things that may have been a bit confusing. Before going home, make sure you are able to do these: ‚

I can tell you about my childs condition.
I can tell you how to care for my child's skin and cast.
I can tell you what I will do if my child has numbness or tingling in the legs, the toes are cold, or there are any problems with the cast.

Where can I learn more?

American Academy of Orthopaedic Surgeons ‚
http://orthoinfo.aaos.org/topic.cfm?topic=A00424 ‚

Consumer Information Use and Disclaimer

This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚

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