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Hip spica (children)

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Home preparation and safety prior to discharge

  • At home it is recommended that a mattress on the floor is used for sleeping as this enables easy transfer from bed—reducing back strain with bigger children.
  • Boys will require large legged shorts or trousers. It is a good idea to velcro underpants at sides for ease of dressing. Underpants will need to be of a larger size than usually worn.
  • The hospital can usually provide a slipper bed pan and skateboard for use at home.
  • The vehicle used for transport home should be large enough so as the child can lie along the back seat. Safety belts should be used to strap the child in.

Plaster care

  • Keep the cast clean and dry.
  • Prior to discharge the nursing staff will tape the edges of the plaster with waterproof protective tape which will stop the edges crumbling andalso stop the plaster rubbing.
  • Make sure your child does not use sharp objects (rulers etc) as “scratchers”. If itchiness is a problem, get in touch with your doctor.

Mobility and positioning of a child in a hip spica

  • Children over the age of four to five years are usually provided with a skateboard (or instruction is given on how to make one) for mobility. The skateboard is a large padded board with four wheels underneath. The child lies on their stomach and pushes themselvesalong using their hands. The skateboard is to be used indoors only!
  • When the child is on their back, one or two pillows only should be used under the head and shoulders to position the child. The child should be placed in a semi reclined position.
  • Do not allow your child to sit up, bend at the waist, kneel or stand in the hip spica. This places stress on the plaster and may lead to cracking. Small children should not be nursed upright in parents arms, but rather “cradle” carried for the same reason.
  • Use a small pillow or rolled up towel to prevent pressure on heels.
  • Until your child is confident in turning themselves over, you should turn the child every two to four hours during the day.
  • When turning your child from back to stomach, turn on side with plastered leg passing over the top of the non-plastered leg. Note: For children in a double leg hip spica, do not use the “broomstick” (bar used for separating legs) as a handle for turning. Nursing staff will instruct you as to how to turn your child in a double leg spica.

Skin care, bathing and toileting

  • Your child should be sponge bathed daily ensuring plaster is kept dry at all times. Sponge time is a good opportunity to inspect plaster for any signs of cracking, softening or areas of rubbing. Visit the closest emergency hospital that treats children for plaster reinforcement if this occurs.
  • The child’s skin should be checked daily for any signs of redness or irritation caused by the plaster.
  • The hospital may provide or tell you where to obtain a “slipper” pan for use at home. Boys can use a jar or the pan to urinate into. You will need to help you child roll onto the pan.

Diet and eating

  • Encourage your child to drink plenty of fluids and to eat fibre foods (e.g. wholegrain cereals, fruit and vegetables) to prevent constipation.
  • The best position for eating is on the stomach on the skateboard with the food on the floor.
  • Avoid crumbs as these may get under the plaster and become uncomfortable.

School and play

School work follow-up will be arranged by the teacher on the ward. Avoid small toys which may find their way inside the plaster. If anything is lost down the plaster, please go to your closest hospital that treats children for an x-ray.

Removal of hip spica

The hip spica will be removed when the bone has healed, usually about six weeks. A special electric saw will be used and works by vibrating. The saw is very noisy, and your child could be frightened by this. It is important to reassure your child that the saw willnot cut their skin.

The skin under the plaster will be dry and flaky. Apply moisturising cream at least three times per day. An x-ray will be taken of your child’s leg at this time.

Mobility after removal of hip spica

Your child may stay in hospital overnight to be instructed in the use of crutches. This will be determined by the physiotherapist.

Emergency contact

To ensure your child receives the best possible care in an emergency, you should call 000 or go to your closest hospital that treats children.

If you have any concerns or questions please contact your doctor.

Mater Children’s Private Brisbane

Salmon Building,

Raymond Terrace,

South Brisbane QLD 4101

Telephone: 07 3163 8111

www.mater.org.au

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Mater acknowledges consumer consultation in the development of this patient information.
Mater Doc Num: PI-CLN-470020
Last modified 09/8/2017.
Consumers were consulted in the development of this patient information.
Last consumer engagement date: 22/6/2015
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