As if having an infant or young child with an orthopedic condition (usually a broken thigh bone or hip disorder) requiring treatment isn’t enough, now you are told your child will need a spica cast!
A spica cast is a cast that extends from the child’s chest down to his or her toes. While it seems insurmountable to care for a child in a spica cast, many parents have walked this road before and have succeeded. You will too! Here are some tips to care for your child in a spica cast:
1. Children in spica casts need hugs too! First and foremost, remember that your child will need your love and gentleness more than he or she needs a spotless cast.
2. Be prepared. Here is a list of helpful items for your home:
- a special car seat, as your child will probably not fit in the regular car seat in the spica cast
- a reclining wheelchair, special stroller or wagon
- diapers in two sizes – one to fit inside and one to fit on the outside of the cast
- sanitary napkins to fit inside the inner diaper for extra absorbency at night
- a bedpan or urinal for older children
- moleskin for rough edges of the cast and to keep the GORE-TEX liner in place
- a hair dryer with a cool setting
- a flashlight to use to see into the cast to check the skin for sore areas
3. Check your child’s skin frequently, about four times a day
- change your child’s position so he or she does not develop skin or pressure sores from being in one position for too long
- check the toes for swelling, movement and discoloration
- use a flashlight to check the skin under the cast for sores or blisters
4. You can bathe your child in a spica cast but it has to be a sponge bath
- use a lightly damp wash cloth to clean the skin under the cast
- do not use powders or lotions as they can irritate the skin
5. Gravity is your friend. Keep the chest above the hips to help direct urine into the diaper and to keep it from pooling in the cast
6. Get out of the house. A change of scenery is good for everyone. Remember to keep your child restrained in any vehicle, high chair or stroller/wheelchair.
7. Eat your vegetables. Due to inactivity, constipation can become a problem. Make sure to include fruits and vegetables in your child’s diet.
8. Fashion trends. Dresses and sweatpants work great. Underpants can be altered to have a Velcro closure for older children.
9. This too shall pass. Having a child in a spica cast is challenging. You are not alone. Make sure to call your doctor’s office with any questions or concerns.
For videos demonstrating the basics of caring for your child in a spica cast at home, click here.
Julia Munn Hale is a certified physician assistant in the Pediatric Orthopedic Surgery Service at Hospital for Special Surgery.