Care of the Child in a Hip Spica Cast


Your child has had an operation or an injury and now needs a hip spica body cast. The hip spica cast is used to keep your child’s hips and legs from moving. This information will help you care for your child in the Spica Cast.

Parents, please make every effort to keep your child’s cast clinic appointment. If you miss the appointment, and the treatment is delayed, your child may have to wear the cast longer. If you are unable to keep and appointment, please notify the clinic to reschedule as soon as possible at 916-453-2180.

Printable Hip Spica Cast Care instructions and also in Spanish.

Cast Care

  • The cast should remain dry, so the child’s skin remains free of sores and rashes. A special, thin lining (Gore-tex) prevents urine and stool from soaking into the cast padding.
  • Use tape to “petal” the edges-to keep the edges dry and clean
  • Use a flashlight to check the skin under the edges of the cast for reddened areas, blisters or rash.
  • Check the cast daily for cracks, dents or change between the skin and cast.
  • Prevent small objects (coins, toys, crumbs) from getting down into the cast, use a bib or t-shirt to cover the cast.
  • Wipe any soiling from the cast, liner or edges.
  • If the “tape petals” become soiled or begin to “roll off” the cast edge, call the Clinic and speak with a cast technician or nurse.

Do not lift your child by the support bar between the legs
Do not use lotions or powders on the skin unless instructed
Do not place the diaper over the cast, urine from the diaper will soak into the cast and cause odor and soften the cast.
Do not allow your child to stick any sharp objects (coat hangers, knitting needles, and pencils) under the cast.

Remember: Do not allow your child to walk or stand unless ordered by your doctor.

Toileting & Diapering

  • Use bedpan/urinal. For girls use a “wick” made with several layers of toilet paper to guide the urine stream into the bedpan.
  • Use damp, soapy wash cloth to remove soiling. Allow cast to air dry.
  • Use smaller diaper than usual.
  • A feminine sanitary napkin can be placed inside the diaper to absorb urine (especially at night).
  • Gently place the napkin over the child’s private area.
  • Use disposable diapers if possible. Keep plastic backing of diaper next to the cast surface.
  • Check the diaper hourly during the day. Check/change the diaper at least once during the night.
  • If using cloth diapers: fold the diaper to the size of the open area of the cast.
  • Place (double thickness) folded diaper over the front for boys and over the back for girls. Dry buttocks well after using the bedpan.
  • Keep sheets and linen clean and dry.
  • The plastic of the diaper will prevent urine form being absorbed into the cast material. Dry skin and clean linen will prevent skin breakdown.


  • Once the cast is dry, shirts, dresses, and skirts may be worn as normal.
  • To use pants, shorts and underwear, split (or cut) side seams and add Velcro strips.

Call the Hospital or Clinic at 916-453-2180 if:

  • The toes are cold to the touch or appear pale or blue.
  • Your child complains of tingling and/or numbness in their toes.
  • Your child cannot move their toes.
  • The toes are swollen.
  • Pain is not relieved by position change-raise (elevate)
  • Pain is not relieved by Tylenol or prescribed pain medications.
  • Your child complains of rubbing, or burning under the cast. This could be the sign of a pressure sore.
  • A bad smell is coming form your cast.
  • Cast tightness, skin redness or breakdown at the edge of the cast