While the Spica Cast itself is not a surgical procedure, the spica cast is generally used after a surgical procedure for hip dysplasia. This is because the hip joint needs to be kept in the new, surgically repaired hip joint position to ensure proper development of the hip joint.
The video below shows an example of a hip spica cast being fitted on a child by Dr. Herrera-Soto on the IHDI Medical Advisory Board:
After application, the spica cast is typically changed every 6 weeks until the child has been in the cast for 3-6 months. Improvement in the hip may not be realized until the first cast change. While your child is in the cast, it’s best to pick him/her up from the waist while supporting the trunk and thighs. Some doctors allow use of the cross bar as a handle but others don’t because of concerns that the cast may break. Either way, it’s best to avoid picking the child up only underneath the arms with the weight of the cast pulling down on the hips.
At the cast changes, an arthrogram (an x-ray with dye) is often performed to check on the progress of the hip joint. The total time spent in the cast depends of the appearance of the hip on x-ray with the arthrogram.
After the final cast has been removed, the child is normally placed into a hip abduction brace for several more weeks. Since the child has been in a body cast for so long, it is important to “wean them off.” During this time it is important to follow your doctor’s prescription, which will normally be to wear the brace at all times, except for baths, in the beginning. The brace allows for more hip movement than a cast. This weaning time helps to reintroduce more range of motion to the hips while the hip is growing and becoming more stable.
After a few weeks in the brace, the doctor will begin to allow more time out of the brace for the child to begin to regain strength and movement. This process can be pretty stressful for parents, but the children generally seem to tolerate it very well. They quickly catch up to other children in all of their activities.
After a year, when the hip returns to normal, it should be impossible to tell children who spent time in a cast from children who were never in a cast.
This process is not always successful and sometimes problems develop during or after treatment.