When Your Child Needs a Spica Cast

Your child needs a spica cast. This is a cast that covers the child’s lower body. It is used to treat problems such as fractures (broken bones) in the hips or thighs. A spica cast reaches from the chest over the hips and down one or both legs. It has a cutout at the groin for toileting. A bar may connect the legs to make the cast more stable. A spica cast is applied by an orthopedist (doctor specializing in treating bone and joint problems). This is often done in an operating room. Your child will wear the cast for 4 to 12 weeks.

You will be given instructions on how to care for your child while he or she is in a spica cast.

When is a spica cast needed?

A spica cast is used to stabilize and protect the hip or thigh area for a set time. This helps problems or injuries in these areas heal. A spica cast may be used after the following: 

• A femur (thighbone) fracture

• Hip or pelvis problems or fractures

• Dislocation (pushing out of place) of the hip joint

• Certain surgeries (such as a tendon release)

Caring for your child

You will be given specific instructions for caring for your child and the spica cast. Here are some guidelines:

• Inspect the cast and your child regularly for:

  • Sharp areas or rough spots near skin.

  • Skin that is red, irritated, or sore.

  • A skin rash around or under the cast.

  • Skin that is numb or changes color.

• Keep the cast dry. Don’t let water get under the cast. Bathe and clean your child with sponge baths, as instructed. Clean the groin area carefully.

• Tape around the edges of the groin opening of the cast. This helps the cast stay clean. Many parents use moleskin or duct tape.

• Diaper your child as instructed by your health care provider. Often, a diaper is put on underneath the opening of the spica cast and another larger one is placed over the cast. A sanitary napkin can be used on the inside diaper to increase absorbency. Change diapers frequently to prevent skin breakdown and soiling of the cast. You will likely have to help a toilet-trained child use the toilet. A bed pan or urinal (for boys) may be needed for older children.

• Just after the cast is put on, limit your child’s activity to let the injury stabilize. Gentle activities include such things as board games, reading, listening to music, puzzles, crafts, and video games. Your child’s doctor can give you specific activity guidelines for your child while the cast is in place.

• Put your child’s clothing on OVER the cast. Loose or larger-sized clothing works best, such as large sweat pants or one piece body-suits for infants. Larger clothing can be cut and velcro applied to ease in dressing the child.

• Change a child's position often, about every 2 to 4 hours. Consider using a bean bag chair, pillows, or a recliner for ease of positioning the child.

• To get around older children may need a reclining wheelchair, which you can get at a medical supply store. Younger children can be placed in an adjustable stroller or wagon. Remember to always use safety straps.

Call your child’s doctor if your child has any of the following:

• Fever, as directed by your healthcare provider or:

  • Your child is younger than 12 weeks and has a fever of 100.4°F (38°C) or higher because your baby may need to see a healthcare provider

  • Your child has repeated fevers above 104°F (40°C) at any age

  • Your child is younger than 2 years old and his or her fever continues for more than 24 hours or your child is 2 years old or older and his or her fever continues for  more than 3 days

• Skin around the cast is red, irritated, or sore

• The toes change color or feel very cool to touch

• Your child can't move or wiggle his or her toes

• A skin rash develops near or under the cast

• Your child complains that a spot under the cast hurts or burns

• Your child’s toes are numb or tingly

• Your child has pain that is not relieved by elevating the legs and using acetaminophen, or other prescribed pain medication

• The cast develops any breaks, cracks, or sharp spots

• If something falls down into the cast and becomes stuck

• The cast gets wet or very dirty, or the crotch opening gets soiled with feces or urine