Caring For Your Child In A Hip Spica Plaster Cast.pdf

A hip spica is a special type of cast used to immobilize the hip joints and/or thigh. It usually extends from the mid-chest or abdomen down to the knee on the affected side. A hole is left in the groin area to allow the child to sit on the toilet or for a nappy to be changed. The cast will vary depending on the intended use, but it is often used to stabilize and promote healing of a damaged joint or fractured femur.

To prevent skin problems, the skin must be kept clean and dry. When changing the nappy, wash and dry the skin at the back as well as the front of the nappy area. Ensure that the plastic covering around the edge of the plaster is kept dry, using a towel. If you observe red areas under the plaster cast, contact the Children's Community Nurse.

You will need to use nappies that are two sizes bigger than your child normally uses so they can fit over the plaster. You may also find it useful to tuck a smaller nappy into the inside of the hip spica to prevent it becoming wet and dirty.

A suitable car seat is necessary to transfer your child securely in the car. There is no car seat on the market made especially for children in plaster casts. Your child may not fit into a car seat with high sides. The best type of car seat for babies is one with low or adjustable sides. You may find that the crutch strap is not long enough, but you may be able to obtain a longer crutch strap from the manufacturers.

You will need to bring your child's own pram or buggy into hospital so that it can be assessed for suitability. A double buggy may seem to be the perfect solution, but they are difficult to obtain, get through shop doorways, and heavy to manoeuvre onto public transport or into or out of a car boot.

When the plaster cast is removed, children will have their cast removed in clinic, then be allowed to go home. For the first few days after the cast is removed, it is essential to move and handle your child as though they still have the cast on. When lifting, support the lower part of the legs, being careful not to let the legs drop from the knees.

You may find that your child is reluctant or frightened to move his/her legs when the plaster cast is removed, and this is normal. You should encourage your child to move their lower limbs. Bath time is a good way to begin this with gentle leg movements such as bending and straightening the knees, and gently bringing the legs apart and together. Do not force the legs together.

It is essential not to stand or walk your child too early. Children will tend to pull themselves up when they are ready. You may find that your child will crawl or shuffle on their bottoms first and gradually use the furniture to pull up and walk. Do not put your child in a baby walker.

The information in this leaflet is for guidance purposes only and is not provided to replace professional clinical advice from a qualified practitioner.