In this section
Hip Spica is a plaster cast that extends from the torso down to the feet and is applied in theatre under a general anaesthetic. The objective of the hip spica is to immobilise the hip, pelvis and/or femur fractures, or post reduction for developmental
dysplasia of the hip (DDH). Hip spicas are generally used for children from 6 months to 6 years of age and may be in place for 6 weeks to 6 months depending on the medical condition. Frequent neurovascular observations and pressure area care are required in the post operative period. The spica nappy
area needs to be taped with sleek prior to discharge to assist in keeping this area as clean for as long as possible. The plaster cast should then be reinforced with scotching/fibreglass. Patients will need to be fitted into a car seat by an Occupational Therapist for all new Hip Spicas. For a change of
existing hip spica or hip brace application Registered Nurses can undertake car seat fitting/modifications.
The aim of this CPG is to guide nursing staff on the assessment and management of children with a hip spica in the post operative period and to ensure that the hip spica is appropriately reinforced prior to discharge.
Figure 1. Example
of sanitary pad tucked under spica and nappy application.
Applying waterproof tape to edges of the groin area.
Alert the orthopaedic team if any pressure areas are noted.
Pressure Injury Prevention and Management
Immediately report to the orthopaedic team for urgent review and management.
syndrome is considered a surgical emergency and patients must be reviewed
urgently by the surgeon if compartment syndrome is suspected.
If neurovascular compromise occurs the orthopaedic team will need to revise, trim, or modify the cast.
Figure 3. Nursing
and Occupational Therapy referral for car sea fitting pathway.
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The revision of this nursing guideline was coordinated by Ebony Larter, CSN, Platypus Ward, and approved by the Nursing Clinical Effectiveness Committee. Updated April 2023.