Pediatric Hip Spica Casting: Casting Technique Guide with Procedural Tips

The purpose of this technical note is to outline our preferred methods of pediatric hip spica casting, not only to assist with placement of the cast, but to provide tips for improved waterproofing and decreased skin complications. At our institution, pediatric spica casts are placed to treat a variety of hip and femur conditions. This step-by-step guide was developed using the experience of our authors. In our experience, following this technique has resulted in successful spica cast placement. Specifically, our use of duct tape as a means of waterproofing the casts has decreased urine and fecal soilage of the cast padding and allowed smoothing over sharp cast edges, thus reducing skin complications. In summary, the pediatric spica cast is a valuable tool for the pediatric orthopaedist. With adequate preparation, the right equipment, and the following technique, these historically tedious casts can be placed safely and efficiently. (Journal of Surgical Orthopaedic Advances 32(2): 127–129, 2023)

Key words: spica cast, waterproof, technique