If you haven’t heard the term ‘spica cast’ before, you will soon know everything there is to know and we are here to help.
Spica casts are worn following surgery and keep the hip socket in place and aid healthy healing and growth.
They can be pretty frightening to start with but in time you and your child will get used to them and you might be amazed at just what they can do when they are in a spica.
Below are the main types of spica cast, they differ from surgeon to surgeon and as with all things DDH you won’t ever get two that are the same.
Full Hip Spica
The full hip cast starts just below the nipple line and goes down both legs to the ankles. Both knees tend to be bent and the child is usually in a semi reclined position.
Sometimes a bar (aka a ‘broomstick’) is added across the middle of the cast and this is to stabilise the legs and strengthen the plaster. It is vital to be careful with this bar and never use it to lift or turn your child as it may break or damage the cast and the little person inside it.
One and a Half Hip Spica
Similar to the full spica, this model means that the affected leg is put in plaster to the ankle (the affected side) and the other to above the knee. Again a bar maybe used with this type of cast.
Lucas wore this cast for 12 weeks following an open reduction and femoral osteotomy when he was two.
Half Hip Spica
In this situation the plaster starts just under the nipple line and goes down the affected leg to just above the knee. The other leg is left free.
For this cast, the plaster spreads both legs wide and goes down to both knees so your child looks like a little frog.
This was the cast Lucas was placed in at eight months when he had a closed reduction and stayed in it for 12 weeks.
Whatever cast your child is put in, padding will be applied next to the skin to minimise the chance of infection and irritation and then fibreglass bandages or Plaster of Paris are wrapped around it.
Strips of pink tape are tucked under the edges around the groin area to make it smooth and provide a waterproof covering of the edges of the plaster.
Post-Cast Hip Abduction Brace
When the spica cast is removed, there is the possibility your child have to wear a hip abduction brace, note that in the US and Australia this is often referred to as a ‘cruiser’ or ‘rhino’ brace.
This is softer, lighter and less constrictive than a spica and allows an element of hip movement but it still supports the joint as it heals and grows. Your surgeon will advise you on how long this needs to be worn for and when it needs to be worn, e.g. 24/7 or just at nap times.