A hip spica cast is one that starts around the chest and goes around the hips and waist. It will go down one or both legs. The cast does have an opening cut out for toilet use/diapering. It may be used to immobilize fractures of the femur and after surgery to maintain a proper position for healing.

We know that caring for a child in a hip spica cast can be challenging. We are providing you with these instructions to help address any concerns or questions you may have. These instructions should be shared with any caregivers for your child.

If your child is in diapers it is very important that you change them frequently. We recommend that you check them for wetness every couple hours. You can "double diaper" or put a maxi pad in the diaper itself to help soak up the urine. "Double diapering" would be inserting a smaller diaper into a larger diaper then tucking both into the opening in the front and back of the cast. Do not place the diaper over the cast.

Remember gravity works in your favor so if the head and shoulders are higher than the feet it will help drain urine or stool into the diaper/maxi pad, keeping the cast dry. You can also tuck an extra maxi pad into both the front and rear of the body portion of the cast.

We recommend that you use waterproof tape around the openings of the cast, especially in the diapering area. We call this "petalling" the cast. Tear 3-4 inch strips in length and tuck one end under the cast and pull the free end to the outside of the cast. You will overlap the strips until you have a complete waterproof edge. Duct tape works well for this. Now with the fun colors this can be an adventure for you and your child.

If your child can use a bedpan, you will need to waterproof your cast as above. If your child is potty trained, you can lift them onto the toilet. It may help to apply a long sheet of plast wrap under rear edges of the cast to help guide urine or stool into the toilet. As soon as they're done, remove the plast wrap, wipe until completely dry then assist them off the toilet. If they need to use a bedpan, roll them to their side to their side, put the bedpan under them and make sure it is in the proper place. You can use the plastic wrap as above to help direct urine and stool. If your child is female, you can take several pieces of toilet paper and use them like a "wick" to direct the urine into the bedpan. Be very careful when removing the bedpan, so not to spill the urine. Some parents have even put a diaper in the bedpan to soak up the urine to help avoid spillage. If you use the toilet seat, you may find a soft vinyl seat to be more comfortable for your child. These can be purchased at a reasonable cost at a home improvement center.

Your child will need to sponge bathe because showers or bathing in a tub is not allowed. When you bathe your child, make sure to check the skin around and inside of the cast. You can use a flashlight to make sure there is not any skin breakdown. Do not get the cast wet. Do not use lotions or powders around the cast because they can cause skin irritation. Do not remove any padding from the cast. If the cast gets wet from urine or slightly damp from bathing, use a blow drying on a cool setting. This may help with itching too.

It is very important not to put anything inside the cast. So, avoid having your child play with small toys that they can insert into the cast. Do not use anything to "help scratch" inside the cast. You could scratch the skin and develop a serious skin infection.

Clothing could be long t-shirts, baggy shorts or pants, onesies for babies, skirts, or dresses. You could adapt pants, underwear, or shorts by cutting sides and replacing with Velcro or ties.

When feeding your child, protect the cast by using a long t-shirt, towel, or bib to avoid getting the cast soiled. Make sure they are seated in an upright position. If child is older, have them sit in a wheelchair at the table with family. If they are younger, avoid foods that are choking hazards. Infants still need to be burped.