Spica Cast Care

A spica cast is a temporary half body cast that allows bones, joints, and tendons to heal. It is often placed on the hips, legs, thighs, and belly (abdomen) of a child. There are many different conditions that may require a spica cast like an injury or surgery. Your caregiver will tell you how to take care of the cast because it can be challenging. Your child needs to be safe and comfortable in a spica cast. Follow up with your caregiver as directed.

BASIC CAST CARE

  • Check the cast daily for cracks and changes.

  • Keep the cast dry and clean. Wash the outside of the cast as needed. Wash it with a damp cloth and mild soap. Allow the cast to air dry.

  • Have your child wear loose clothing over the spica cast (unless you are air drying it). This will protect the cast.

  • Have your child wear a bib or towel to cover the cast while eating.

  • Your caregiver may have you "petal" the spica cast. This means lining the edges of the cast with soft, smooth tape or moleskin to protect the skin. For each edge or opening:

  • Cut 4 inch strips of tape or moleskin.

  • Stick 1 end under the edge of the cast onto the cotton liner.

  • Fold over the rest of the tape or moleskin, and stick it onto the outside of the cast.

  • Continue this process by overlapping strips to make a sealed edge. 

GOING TO THE BATHROOM

  • An older child may use a bedpan or toilet to go to the bathroom.

  • Wipe and dry the buttocks well.

  • With girls, wipe front to back.

  • Change the bedding or pants right away if they become wet or dirty (soiled).

  • A younger child will be in diapers.

  • Use disposable diapers and onesies that snap at the crotch if possible.

  • Make sure the diaper is small enough to tuck under the cast. The diaper must be tucked under both front and back of the cast. It is okay to place the child on their abdomen to make it easier to tuck the diaper under the back of the cast.

  • You may put a sanitary pad in the diaper for more absorption. This is helpful at night. A diaper made especially for nighttime may be used for increased absorption as well.

  • A larger diaper may be worn outside of the small inner diaper, and over the spica cast for protective purposes.

  • You may use an elastic belt to keep the diaper in place, if necessary.

  • Change diapers regularly to prevent cast soilage. 

CIRCULATION AND SKIN CARE

  • Check your child's toes the first 3 to 4 hours after the cast is put on. Your child's toes should be pinkish and warm, with no swelling. Make sure your child can wiggle his or her toes just like before the cast. Make sure he or she can feel your touch.

  • Check that your child has the same amount of room between the cast and skin every day.

  • Check your child's skin every day in bright light. Look for reddened areas near the edges of the cast. Feel around for sores. Call your caregiver for further instructions if you find redness or sores.

  • Carefully give your child a sponge bath with warm water and mild soap every day. Try not to wet the cast.

  • Do not use any lotions or powders on your child's skin.

  • Do not stick any objects under the cast.

  • Put rubbing alcohol or a solution prescribed by your caregiver on the skin near the edges of the cast 2 to 3 times per day. This will help toughen the skin. Stop if the skin becomes too dry or cracked.

  • You may blow cool air into the cast with a hair dryer on the lowest setting for cooling and itch relief.

KEEPING YOUR CHILD COMFORTABLE AND SAFE

  • Never leave your child alone on a bed or chair.

  • Keep their head and upper body elevated at all times. This will keep stool and urine from leaking back into the cast. Your child will let you know which positions are comfortable, but make sure he or she is slightly elevated.

  • Change your child's position every 2 to 4 hours.

  • Ask your caregiver for the best sleep positions for your child.

  • Make sure small objects do not get under the cast.

GETTING AROUND

  • Plan for gentle activities, such as board games, reading, and video games.

  • Pick your child up by supporting the cast, the leg area, and the upper body. Put 1 arm under the bottom of the cast and 1 arm under the child's opposite arm. You may use the abduction bar to help carry or lift the child. Do not pick up your child by the armpits.

  • You may use pillows to prop your child in a wagon or an adjustable stroller. Make sure to use the safety belt.

  • Reclining wheelchairs and other vehicles are available from the hospital or medical supply store.

  • Your child should not stand or walk in the cast unless your caregiver recommends it.

DIET

Give your child plenty of fluids and fiber-rich foods to prevent constipation.

SEEK MEDICAL CARE IF:

  • Your child's toes or fingers:

  • Are cold and look bluish.

  • Are numb or lose feeling.

  • Are swollen or painful.

  • Your child has pain that is not relieved by medicine or elevation.

  • Your child has persistent itchy feelings under the cast.

  • Your child complains of burning or soreness under the cast.

  • You notice a bad smell coming from the cast.

  • You notice staining on the cast.

  • You notice skin changes, such as redness, cracking, or sores near the edges of the cast.

  • An object gets stuck in the cast.

  • Your child's cast seems too tight or too loose.

  • Your child's cast breaks, splits, or starts to fall apart.

  • Your child has an unexplained fever or fussiness.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Your child's toes are blue, pale, or the color does not change after gentle pinching.

  • Your child is complaining of increasing pain in the cast area.

  • Your baby continues to cry as if in pain and cannot be comforted.

  • Your child has drainage from the cast.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your child's condition.

  • Will get help right away if your child is not doing well or gets worse.