Hip Spica Cast Care
A hip spica cast is used for many reasons.
The amount of bend at the hips, whether
both legs are included in the cast, and how
wide the legs are spread vary depending on
what your doctor is treating. The
suggestions below are meant to be used as a
Not all of the tips below will work for every
child. It is important to keep trying different
positions, diapering, and cleaning techniques
until you find one that works best for you
and your family. Taking care of this cast
can be a challenge.
Always keep the head and upper body
elevated above the cast. This will help to
decrease the chance stool or urine will leak
into the cast. Your child may lie flat for
diaper changes if needed.
Some children prefer
ξ a bean bag chair
ξ a Boppy pillow
ξ a recliner
It is important to change the position of your
child every 2 hours during the day and every
3-4 hours at night to prevent skin issues.
This can be done at the time of diaper
changes. Turn your child on his/her back,
sides and stomach. Place a rolled towel or
pillow under their calf or shin when laying
on their back or stomach to take pressure off
of their heels and toes.
Do not leave your child alone.
He will be unable to catch himself if he
falls from a bed, chair or pillow.
It is crucial when picking up or carrying
your child that you always support the cast
from the bottom with your arm under both
legs. Do not pick your child up from under
Before you leave the hospital someone will
help you decide if your current car seat or
booster seat will work with this cast. If not,
a different car seat or harness will be
ordered while your child is in the hospital.
Most items can be rented.
Changing diapers and preventing leaks can
be a challenge. We suggest using a three
layer method. The first layer is a thick maxi
pad. It should be tucked into the diaper
area, from front to back, to fill the opening
in the bottom of the cast. The second layer
is a very small diaper. It is also tucked
inside the cast over the maxi pad. The third
layer, or outer layer, is a large diaper that
fits over the cast. We suggest using one that
is 2 sizes larger. Change the inner pad and
diaper every 1-2 hours during the day and
every 3-4 hours at night. If your child uses
the toilet, you may use a bedside commode,
bedpan or urinal.
Skin problems are common in children with
a hip spica cast. Keeping the cast clean and
dry and repositioning your child frequently
will help prevent issues. Check your child’s
skin during diaper changes. A flashlight can
be used to help see inside the cast. If
redness in seen, keep the area dry and open
to the air, and call the clinic for further
recommendations as medication or specific
ointments may be necessary.
Small, frequent meals are tolerated best.
Large meals may make your child
Do not make significant changes to your
child’s diet or add new foods as this could
cause stomach upset and diarrhea. Have
your child eat plenty of fresh fruits and
vegetables as well as whole grain foods to
If you have any questions please call our clinic.
Pediatric Orthopedic Clinic: (608) 263-6420 (Monday through Friday 8:00 am - 4:30 pm).
After hours and on weekends, this number will be answered by the paging operator. Ask for the
orthopedic resident on call. Leave your name and phone number with the area code. The doctor
will call you back.
If you live out of the area please call: 1-800-323-8942.
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 10/2016 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing HF#6622.