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The University of Chicago Medicine - Comer Children's Hospital

Care for a Child with a Hip Spica Cast

Skin Care

  1. Keep skin clean and dry. Eliminate plaster/fiberglass crumbs or foreign objects. Do not allow child to place small objects down in the cast. It can cause severe pressure areas.
  2. Turn the child during the day to lie on his/her abdomen several hours a day. Be sure when in this position, a pillow is under the knee of the cast and under the chest.
  3. Look and feel for skin irritations at cast edges.

Check for the following:

  • Swelling and discoloration of the toes
  • The child's toes can move and are warm
  • Pay attention to complaints of pain, numbness, or tingling.
  • If a small child or infant is irritable or fussy, this may be a sign that there is a problem. If in doubt about any of these things, consult your doctor.

Drying the Cast

Do not wet the cast. If it gets wet, expose the area to air or dry with a soft, fluffy cloth.

Cleaning the Cast

If the cast becomes soiled from bowel movement, it may be cleansed by using a damp (not wet) cloth with mild soap, such as dishwashing liquid soap.

Placing the Child on a Bedpan

Elevate the child’s head and shoulder by using pillows when he or she is on the bedpan. A folded diaper, soft cloth, or gauze pad placed on the back of the bedpan will absorb any moisture and keep the cast clean and dry.

Protecting the Cast

On a baby or small child, plastic water-proof material may be used to protect the cast around the perineum and buttocks.

A perineal diaper may be used on a child who is not toilet trained. Fold a diaper in the form of perineal pad and place it across the perineum tucking it under the edges of the cast in front and in back.

It is essential that this pad or diaper be changed as soon as it becomes wet or soiled. Inspect it frequently for wetness. Apply petroleum jelly around the perineum and buttocks to avoid urine contact on the skin and prevent skin rashes.

To eliminate plastic crumbs and provide smooth edges for the cast, adhesive tape may be used to bind the edges of the cast. Wait until the cast is dry (at least 24 to 48 hours).

Other Instructions

  • Do not leave the child alone at any time.
  • The child’s buttocks should be cleansed thoroughly after each bowel movement with soap and water. Keep the child’s skin clean and dry, and apply petroleum jelly around exposed buttocks.
  • Do not let the child attempt to walk with the cast on. Neither should you allow your child to sit up while in the cast. The cast might break and would have to be replaced immediately.
  • Do not use the bar in the middle of the cast to carry or turn your child.
  • Your child can eat regular food unless otherwise ordered. Please encourage your child to drink plenty of water and fruit juices.
  • You may use baby powder under the cast to help prevent itching. You may bathe your child by sponge bath wherever he or she is not covered with the cast.
  • Any foul smell around the area of surgery must be checked.

Notify your child's doctor with any problems or concerns regarding the care of your child.