You should definitely check the skin at least times a day for any redness or areas of irritation. Positioning and frequent diaper changes are the key to avoiding the common problem of skin irritation.
It is not a good idea to put lotions, creams, or powders down the cast as this will often make the skin condition worse. If itching is a problem, first try the cool hair dryer and position changes. In general, the itching will decrease as your child becomes accustomed to the cast. NEVER stick anything down the cast to scratch the skin!! This will often lead to skin irritation and could also cause a secondary skin infection.
If you are concerned about skin redness or skin irritation, you can always contact our office at As always, nutrition is very important. There are a few things you can do to help prevent problems associated with being in a cast. Feeding your child fresh fruits, vegetables, and whole grain breads increasing fiber will often help prevent constipation. It is also important to drink plenty of water and juices to prevent dehydration. New foods have a higher likelihood of causing loose stools or diarrhea.
If this occurs, diaper changes will need to be made more frequently and skin care becomes even more important. If the cast does get soiled or your child has diarrhea that is in the cast, please contact our office immediately. If your child complains of a tight feeling in the cast and being full, you may want to try giving smaller, more frequent meals. To prevent food from falling down into the cast while eating, a large shirt or towel should be used to cover the front of the cast.
The hip spica cast will add extra bulk, so larger clothing will often be necessary. Sweating under the cast can cause itching. For the majority of patients, a t-shirt, nightshirt, or loose dress may be the only clothes that are needed. Young children may want to wear clothes that cover the cast more.
Large t-shirts, pants that button up the side, loose dresses, etc can usually be worn over the spica cast. Clothes can also be adapted by cutting the seams as necessary and sewing in Velcro.
Again, it is a good idea to experiment with several different types of clothes and see which one works best for you and your child. Be very careful NOT to get the cast wet. The skin around the spica cast should be washed with gentle soap and water. Do not put anything under the cast, including lotions, powders, or oils. Lotions can often macerate and soften the skin, making it easier for the skin to break down.
While cleaning the skin daily, it is a good idea to check carefully beneath the case edges for areas of skin irritation, redness, blistering, open areas, or pressure spots. It is often helpful to use a flashlight to look down cast edges for any area of skin irritation. While in the hospital, you will learn how to turn and position your child. If your child is potty trained Depending on the position of the cast, your child may be able to sit on the toilet. If not, you will need to use a bedpan.
Boys can use the urinal from the hospital. For girls, a paper cup with a small hole in the bottom may help to direct urine into the bedpan. It may help to use plastic wrap to protect the cast when potty-training children are using the bathroom.
What if the cast gets wet? First, prevent another accident by reviewing the diapering method. If the cast gets soaked, it will take a very long time to dry. You can help speed this process up by using the blow dryer on the cool setting or taking the child out into the sun. Your child's own body heat will also help to dry the cast. Remember, it's important to reposition your child so that different areas have the opportunity to dry.
The back of the cast is the most common place to get wet. Your child will need to have sponge baths. If body odor becomes a problem, you can sprinkle a small amount of deodorant body powder on the cast or spray a small amount of under-arm deodorant on the cast. Do not spray the cast with household cleaners or deodorizers such as Lysol. Clothes should be loose and comfortable.
T-shirts should be sizes larger than usual to fit over the cast. Boxer shorts or sweat pants in a larger size can also fit over the cast. You may also want to cut shorts or sweatpants and sew in Velcro to allow older children to wear their regular clothing. Breakaway shorts with snaps on each side can be used with casts that have a bar connecting the legs of the cast.
Your child may be warmer than usual. Light clothing may be all that's needed. If your child complains of pain, give pain medicine as directed by your doctor.
Pain medicine may be needed at night for weeks. Keep your child where the action is. You may want to bring the child's bed to the living room so they can be where everyone is. This will also save you from running back and forth. Your child will not be able to stand on their injured leg but may be able to stand on the opposite leg. This will allow them to help with getting in and out of bed. A physical therapist can help show you this. Your child may need home instruction for the duration of the casting due to the amount of care needed during that time.
The Orthopedic Nurse Clinician will help arrange this with your school district. The healthcare provider will tell you when your child can return to school. Generally your child should be off of narcotic medication during the day before returning to school. Weekdays: Please call the Orthopedic Nurse Clinicians at Nights or weekends: Call and ask the operator to page the Orthopedic Resident on call.
If your child's surgery is scheduled in advance, you'll have time to arrange transportation ahead of time. The surgeon is usually able to tell you the approximate size of the cast, that is, how wide it will be, and how much it will bend at the knees. Depending on the width of the abduction of your child's legs, your child may not fit safely into their car seat.
The Orthopedic Nurse Clinician can help you figure out what would be best. Sometimes children in spica casts fit in a conventional convertible car seat with lower sides and a wider front especially one that will recline in both rear-facing and forward-facing positions. It will depend on your child's weight, height and age. What if my child does not fit in their car seat? Please arrange for this as soon as you find out the date of surgery.
The Trauma Department attempts to keep these in stock but cannot guarantee a supply. You will need to come into the Trauma office and sign the agreement for financial responsibility. You will be given guidance on how you can install the seat correctly and resources to have the car seat checked for proper installation in your vehicle. You will need to return the seat to the Trauma office or in the Emergency Department if Trauma is closed at the time of your orthopedic follow-up appointment.
Please do not plan to leave the car seat in the Orthopedic Department. This vest is for children aged 2 to 12 and weighing from 20 to pounds. The M2 fits children better who are years old, pounds. The MXS fits snugger on children years of age, pounds. When using the modified EZ-ON vest, your child must travel lying down in the rear seat of the vehicle. See www. It is for educational purposes only and is not intended to replace the advice of your child's doctor or other health care provider.
We encourage you to discuss any questions or concerns you may have with your child's provider. Download a PDF of this info. If your child needs crutches after surgery or an injury, learning how to use them can be confusing. Watch our videos in English and Spanish to learn how. Your child's arm or leg is still healing even after the cast for a broken bone comes off.
Find out what to expect and get tips for play and exercise. A large dish may be placed under your child's head to allow for hair washing with a cup or jug.
Or, one adult can support the child on their knees while seated beside the bath, while the other adult washes the child's hair. Lifting When lifting your child, it is important to support them and the weight of the plaster. Keep your child as close as possible to your own body when picking them up. This helps prevent straining your back and helps make your child feel secure. Older children in hip spicas can be very heavy and an OT may be able to suggest equipment to help with lifting e.
If you have any concerns about lifting your child or concerns about the amount of support you have at home, please discuss these with your child's nurse. If there is a bar across the legs, this can be used for lifting after the plaster has a fibreglass outer layer applied scotching. Positioning Children in a hip spica cannot move easily, so you will need to change their position often to avoid sores developing under the plaster.
Position changes should be made every two to four hours, during the day and night. You can do the changes during nappy checks. Positions include laying on their back or on either side using pillows or rolled up towels for support.
Children can also be positioned on their stomach, supported by pillows, for short periods of time under direct supervision of an adult. Every time you change your child's position, check that the plaster is not digging in and is not too tight around the edges tummy, ankles, groin and knees. Also check this when placing your child in the car.
Make sure your child's heels, feet and toes can move freely after each position change. Make sure their feet are not pressed into the mattress or chair, as this could cause pressure sores, especially when positioned on the stomach. If your child develops a reddened area on their spine, they may need to spend more time on their stomach. If your child is eating solids, you may need to feed them smaller meals more often because the plaster is tighter around the stomach.
Sit your child as upright as possible when feeding. It is a good idea to do this in their pram or wheelchair, ensuring your child is well secured.
Encourage your child to eat plenty of fruit and vegetables and to drink lots fluids to help prevent constipation and to promote healing. Clothing Dress your child in larger clothing so it can fit over a hip spica.
Smaller children may only need a T-shirt or jumper and socks. Pull socks up over the plaster so they are not tight around the ankles. Underwear for older children can be altered with Velcro, press-studs or ties on the sides. Where there is a bar between the knees, it may be easier to place the Velcro or press-studs on the inside of the legs. Skin care Skin around the edges of the plaster should be checked every day for redness, blisters, pressure areas or skin irritations.
Your child will be growing, so check regularly to make sure the plaster is not too tight. Powders and creams should only be used on skin that you can see. Do not put any powder or cream under the plaster because this can cause skin irritation. Be sure your child does not poke things down the plaster, even if itchy. Items poked down the plaster can cause sores and may become stuck. Entertainment Your child will adjust to being in a hip spica very quickly and should continue with their regular routines as much as possible.
Toys should be placed within easy reach. When to see a doctor Call your GP or OT if: you notice any sores or blisters on the skin under the edges of the cast your child has a high temperature that cannot be explained by a cold, ear infection or other illness there are cracks, breaks or softening of the plaster your child's toes are bluish, reddened, swollen, very hot or very cold if there is an unusual odour bad smell coming from the plaster which cannot be explained by soiling poo or wee if the cast has become too tight.
Follow-up You will be advised when your child needs to have a follow-up appointment with a doctor — this is usually six weeks after surgery. Key points to remember Children in hip spicas need special care.
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