Spica Cast Advice

What to expect (and how to cope) when your child with
congenital hip dysplasia is placed in a spica cast.

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Caring for your Spica Cast

Before we get into the details of how to transport and care for a hip dysplasia child in a spica cast, let's first focus on your child's comfort in the cast.

Four Golden Rules for a Spica Cast

  • Make sure you cover (or "petal") the sharp edges of oyur cast
  • Always keep the cast clean and dry, or it will irritate the skin
  • Do not let small things (or spit-up) fall into the cast, or it will irritate the skin
  • Do not use oils and powers on the skin as it will cake up in the cast

Petaling (Padding) the Edges

In most cases, your doctor will put a fiberglass cast on your little one. Fiberglass can have very sharp edges, and very few tapes/adhesives will stick to it. Therefore, the first thing you should do is make sure that your doctors is 1) filing down the sharp edges and 2) padding the edges at the top, crotch and ankles by "petaling" the cast with waterproof, padded tape or moleskin.

If they don't do this... fear not. You can do it yourself.

When it comes to filing down sharp edges, a metal nail file will do the trick.

And when it comes to petaling the edges (lining the sharp edges with waterproof, padded tape), moleskin is the greatest product in the world because it's thick, soft, and the adhesive sticks well to the fiberglass exterior of the cast. If you buy some, I'd get more than you feel you need since you very well might want to replace it over time (e.g. when it gets wet).

While I haven't tried it, I've also had multiple people tell me that Nexcare's waterproof first aid tape also has a strong adhesive that will stick to fiberglass casts.

If your cast is lined with non-Gore-Tex materials like cotton, then simply follow these instructions:

  • Cut several strips of petaling tape to a length of about 4 inches.
  • Tuck one end of the tape under the edge of the cast, and apply the tape to the cotton lining. Place the free end of the tape onto the cast's outside surface.
  • Continue to overlap the strips until a complete edge is formed.
  • Cover all edges of the cast, paying special attention to the diaper area opening.
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    Illustration of petalling on a spica cast

However PLEASE NOTE... we've read that you are not supposed to use moleskin with a cast that is lined with Gore-Tex since it could damage the underlying material. While we haven't tested it, we've read that duct tape is acceptable in these cases.