Your child needs a spica (or body) cast to keep the bones of the leg bones heal well.
The Cast
The cast is made out of fiberglass bandages that are dipped in water and fitted to the child’s body by the doctor. When the bandages are first put on, they will feel cool but as the cast hardens, it will feel warm inside until it completely dries. This is normal. While the cast is drying, handle it gently with the palms of your hands, this will keep from making dents in the cast. To help the cast dry evenly, turn your child from back to side and from side to stomach at least every two hours. Support the cast with soft pillows. Keep the cast uncovered the first night to help it dry quickly and completely.
What to watch out for:
Swelling under the cast
After the cast has been put on, check for signs of swelling every hour for the first four hours, then every four hours for the first 24 hours, and then twice a day.
- Feel and look at your child’s feet. They should be warm and pink. Press on each toenail—they should turn white and then the pink color should return right away. If one or both of your child’s feet are cold, blue, or pink color does not return right away on the toenails, this is a sign that the cast may be too tight.
- Ask your child to wiggle his/her toes or see if your child is able to wiggle them when touched. If your child cannot move the toes, complains of pain, or is very fussy, this is a sign that the cast needs to be checked right away.
- Ask your child if his/her toes feel numb, tingly, or “asleep”. Have your child close their eyes and then press on each toe. Your child should be able to tell you which toe you are touching. If your child cannot feel your touch or complains of numbness or tingling, this is a sign that the cast needs to be checked right away.
A sore or infection under the cast
Check for the following signs of a sore or infection:
- A bad smell coming from under the cast.
- Fever or new pain.
- Loss of energy.
- Your child complains that a spot under the cast feels sore.
IF ANY OF THESE SIGNS DEVELOP, CALL YOUR CHILD’S DOCTOR IMMEDIATELY.
Cast Home Care
Keep the cast dry
If the cast gets wet, it may lose its shape, causing the bones not to heal, the skin to become irritated, or sores or rashes to develop. IF THE CAST ACCIDENTLY GETS WET,
CALL THE DOCTOR.
Keep everything out of the cast
Small toys, food pieces, or other things can cause skin sores if they slip under the cast. Keep the edges of the cast covered with clothing (especially when eating) to keep anything from getting inside the cast. Do not let your child try to scratch the skin under the cast.
Do not wash the cast
Use a barely damp cloth for small spots if desired. If people sign or draw on the cast, make sure the cast is completely dry before writing on it.
Give the skin special care
Give your child a sponge bath each day. Use a damp, soapy washcloth, then rinse and dry the skin. Keep the cast dry. Do not use lotion or powder on the skin around the cast edges. Check the skin near the edges of the cast every day to see if there is any redness or irritation. For extra skin protection, cast edges may be covered or “petalled” with a soft fabric called moleskin.
Turn your child
When your child is in the spica cast, you should change his/her position at least every four hours while awake. Use pillows or rolled up blankets to support the cast and make your child comfortable. DO NOT USE THE BAR BETWEEN THE LEGS AS A HANDLE—the bar could break or the cast can become weak if you pull on the bar.
Toileting
While in the body cast, it is important that your child drinks lots of fluid and eats foods high in fiber (fresh fruits and vegetable, whole-grains) to prevent constipation.
If your child is potty-trained, you will be shown how to help your child use a bedpan or urinal.
If your child wears diapers, use a small diaper to cover the entire groin area and then apply a larger size diaper for extra protection to keep the cast from dry.
Dressing your child
Clothing should be loose fitting and at least two sizes larger than your child’s usual size. Pants should have elastic waists. For ease, you can slit the side seams of pants or shorts and then sew on snaps or Velcro.
Special Equipment
A seat can be made from a bean bag chair, car seat, stroller or wagon with small blankets as padding. A reclining wheelchair can be rented from a medical supply company if desired. Also, carts or other wheeled devices can be used by your child to roll around using her/her arms to push while lying on her/her stomach.
Follow-Up Care
Your child needs to be seen for a check-up and/or x-rays by:
Doctor/Clinic: ____________________________________
Date: ___________________________________________
Phone Number: __________________________________
YOU MUST CALL AND SET UP THIS APPOINTMENT. For any problems before your appointment, call the doctor.
