A spica cast is often used for hip dysplasia and for fractures that require the thigh bone and pelvis to be kept still. Children who have spica casts need special care to prevent possible complications.

Child in a spica cast.Share on Pinterest
Pisecky, L., Großbötzl, G., Gahleitner, M. et al. Results after spica cast immobilization following hip reconstruction in 95 cases: is there a need for alternative techniques?. Arch Orthop Trauma Surg 142, 969–977 (2022) CC BY 4.0

A spica cast is a type of cast used most often to treat hip conditions like developmental hip dysplasia. This type of casting may also be used during treatment for significant injury or bone fractures that require immobilization (preventing movement) of the hips.

If you’ve been told your child needs a spica cast or you’re planning to care for a child who has one, you may be wondering: What is a spica cast? How long will my child be in a spica cast? How do you care for a baby in a spica cast?

Always discuss any medical questions and concerns you have with your child’s doctor, but we’ve gathered some information about spica casts to help you feel more prepared.

Spica casts keep the thigh bone and pelvis still. They are used to keep an individual’s hip joint bones immobilized in the proper position while they heal.

A spica cast covers a child over both their legs (one leg may be only partially covered depending on the exact reason for the spica cast), their waist, and their abdomen. A hole is made at the genitals, so that urine and waste can come out.

A spica cast is put on in the operating room under general anesthesia.

The inside layer of a spica cast is made of Gore-Tex to whisk away moisture. Next, there is cotton padding. Finally, covering that is fiberglass. There might be a bar between the legs to add more stability to the cast, depending on the doctor’s preference.

A waterproof tape will be applied to the cast around the genital area to help prevent the cast from being soiled.

A spica cast may be used when an infant has developmental hip dysplasia (DDH). It can also be used when a child less than 6 years old has a femur fracture or hip/pelvis surgery.

The amount of time a child needs to be in a spica cast will vary depending on the reason for the cast. It can range from about 6 weeks to 3 months. If the cast is going to be on for more than 6 weeks, your child’s doctor may want to redo the cast.

One of the hardest aspects of caring for a baby in a spica cast is keeping it clean and dry. It is generally recommended to cover your child’s cast when they are eating to prevent food from getting on and inside the cast. Additionally, sponge baths can promote good hygiene while keeping the cast dry. Lotions, oils, and powders should not be used inside the cast.

Your child will need help bathing and going to the bathroom. If your child is still in diapers, you may need to use special double-diapering techniques to ensure that no leaks cause the cast to get wet. You’ll typically need to check the diaper for wetness every few hours during the day and at least once overnight to prevent leaks.

You will need to reposition your child frequently to prevent bed sores, reduce swelling, and increase comfort. You’ll also want to keep an eye out for signs of sores or infection. Pillows can be used to elevate their feet and make your child more comfortable.

One final thing to keep in mind is that children in a spica cast should never be left home alone. You may need a wagon or reclining wheelchair to help you transport your child, and they will need a special car seat.

When diagnosed early and treated appropriately, a spica cast can help children with DDH to develop a normal hip joint.

One study looked at the effects of a spica cast on 83 patients 19 years old and younger. Complications occurred in 23 of the patients, with superficial skin lesions being the most frequently reported complication.

The researchers concluded that the number of complications with spica casts can be lowered by making sure the cast is well applied with sufficient foam padding. They also noted the need to observe for complications like skin lesions.

Practices around spica casting may change in the future as research offers more guidance into what amount of casting offers the most benefits with the least complications. Recent research indicates that shorter periods of bracing can lead to fewer complications without raising redislocation rates. Research has also indicated that single-leg spicas may provide sufficient stability.

What should I do if my child is itchy under their spica cast?

If your child complains that they are feeling itchy under the cast, you can use a blow dryer set on the cool setting to blow air down the cast. You can also try scratching another part of the body. You should never allow your child to pull the padding out of the cast or put anything down inside the cast.

What kind of clothing should a child wear with their spica cast?

Your child may need to wear a shirt or dress that is a size or two larger than normal. Boxer shorts or sweatpants in a larger than normal size may also fit with a spica cast, especially if they are split on the side and held together by velcro or ties. The cast may make your child feel warmer than usual, so they may not need as many layers of clothing.

When should I contact my child’s doctor about their spica cast?

You should notify your child’s doctor if the cast is cracking, softening, or if liquid is draining from the inside. You should also notify your child’s doctor if your child experiences blisters and sores inside the cast or has swelling, discoloration, or coolness of the legs and feet. It’s important to contact their doctor if they develop a fever without a known cause, too.

Infants with hip dysplasia and young children with femur fractures may require a spica cast. Spica casts may be used after pelvic or hip surgery, too. These special casts cover the child’s abdomen as well as their waist and legs.

Children in spica casts will require extra help. It’s important to keep their cast clean and dry. If you have any questions about your child’s care while they are in a spica cast, you should reach out to their doctor or contact the number provided by the surgical team.