Care of the hip spica cast
A hip spica cast is a cast that covers the body. It starts at the chest, goes around the waist and hips, and continues down the legs. It has an opening cut out for diapering or toilet use.
A hip spica cast may be applied after different types of hip or leg surgeries, tendon releases or a broken bone. It serves a very specific purpose: to immobilize the hips and legs, and to maintain the corrected position for healing.
Position and comfort
Keep your child’s head and upper body in a semi-sitting position at all times. Do this by propping your child’s head up on pillows.
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Your child may need frequent position changes for comfort, including tummy time.
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Do not use the crossbar or the cast to lift or move your child.
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Do not let your child’s feet and heels rest directly on the mattress. This can cause pressure sores. Place small pillows or a rolled towel under the calves to keep heels and feet off flat surfaces.
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Most clothes can be fitted to keep your child comfortable. Button-down or large T-shirts and loose dresses slip on and off easily. Baggy shorts or pants can be split on one side (you may want to add Velcro or ties so that your child can fasten his pants). Even loose dresses can be worn easily.
- If the doctor tells you that your child can stand, follow these directions:
– Stand your child against a wall, facing you.
– Sit on a chair in front of your child to make sure he does not fall.
– Do not leave your child standing without supervision.
Toileting
There is an opening in the diaper area of your child’s cast for toileting. Your child may have skin and odor problems if this part of the cast gets wet.
Using a bedpan
Older children may come home from the hospital with a bedpan and urinal.
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Prop your child into a semi-sitting position to use the urinal. To use the bedpan, gently turn your child to one side and place the bedpan under his buttocks. Then turn his back onto the bedpan. Check between your child’s thighs to make sure the bedpan is in the right place.
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A “wick” can be made using several pieces of toilet paper guiding the stream of urine into the bedpan for girls. A long sheet of plastic food wrap may be placed inside the rear edges of the cast and hung into the bedpan. This will also help guide urine or BMs, keeping the cast and bed dry. Make sure to dry the buttocks after using the bedpan to prevent rashes.
Using the toilet
If your child is light enough, you may be able to be lift him on and off the toilet. A long sheet of plastic food wrap may be put under the rear edges of the cast and hung into the toilet. This will help guide urine or BMs into the toilet. Remove the plastic wrap as soon as your child is finished. Make sure to dry the buttocks afterwards. Use a bedpan if your child is too heavy and you cannot lift him safely.