Spica Cast Care

A spica cast (body cast) may be used to treat a femur fracture, to immobilize the hip following a surgical procedure or to stabilize a dislocated hip. It involves placing casting material from the nipples down to the toes on one or both sides. An opening is made at the perineum (genital area) to allow for urine/stool elimination.

Spica Cast Care Tips

1. Allow the cast to dry
A plaster cast will take approximately 24-48 hours to dry; if of synthetic (fiberglass) material, the cast is dry in approximately 20 minutes.

Turn the child frequently (every 2 hours) to allow for complete drying and to prevent pressure sores from developing inside the cast. The cast may be placed on his/her side, back, or stomach as long as support is provide and he/she is positioned safely.

2. Circulation checks
Observe for swelling in the feet and toes, especially in the first 8 hours. Elevation of the lower extremities helps prevent some swelling. If toes become discolored, swollen or cool, or if pain becomes severe, please notify your physician.

3. Hygiene
Hygiene is important to keep your child comfortable. Sponge bathing will be necessary until the cast is removed. Do NOT allow the cast to be submerged in water, While bathing, check the skin, especially at the cast edges, for redness, blisters or sores.

If your child is not toilet trained, Serenity® pads or disposable diapers may be tucked snugly in the perineal opening. These must be checked often (every 2 hours) and remove promptly when soiled to avoid urine/stool from soiling the cast padding and irritating the skin. Placing the child in an upright position or resting with the head of the bed elevated may help prevent urine from running back into the cast.

If a GORE-TEX® Pantaloon is made to provide a barrier to soilage, this should benefit your child by:

• Reducing odor
• Improving hygiene
• Eliminating soiled padding

The Pantaloon allows perspiration and moisture vapor to escape from the cast while providing a barrier to liquid. Therefore urine/stool cannot pass through the pantaloon to soil the padding. Take special care not to damage the cast liner. Do NOT use any oils, oil-based lotions or powder inside or near the cast as it may interfere with the performance of the Pantaloon and could cause discomfort or irritation to the skin.

Do not pull out or rearrange the cast padding or place additional padding inside the cast.

Constipation may occur due to decreased activity. Fruit juices and raw vegetables (fiber) may help prevent this condition. If it persists, a laxative such as a glycerin suppository may be used.

Be sure to cover the cast with a towel, shirt or bib while your child is eating to prevent food or drink from falling into the cast.

4. Transportation
With the added weight of the cast and awkward positioning of the lower extremities, children are often difficult to lift and maneuver. Wagons or reclining wheelchairs may be useful as a means of transportation out of the home.

A limited number of car seats for loan are also available for those children 3 years or younger that have been placed in an abduction spica cast. We will discuss your particular needs prior to discharge home and make arrangements as necessary.

5. Clothing
If your child was placed in a Pontoon spica, large leg shorts or pants may be split on the side and Velcro or ties sewn in place in order to cover the cast. Loose shirts or dresses may also be worn.

6. Homebound teachers
School age children are often unable to return to school for 6-8 weeks due to immobilization in the spica cast. Appropriate referrals/request will be made prior to your discharge home if needed. Contact your nurse or the instructors with The Sunshine School (Department of Child Life Services - extension 9651).

Contact Your Physician / Nurse if:

• Your child has pain or swelling
• Your child develops a fever (greater than 100°)
• Your child develops a blister or sore inside the cast, or develops redness at the cast edges
• You notice any unusual odor from the cast
• The cast becomes badly soiled, develops a soft spot or break
• You have any questions regarding your child's care