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A hip spica cast is used for many reasons. The amount of bend at the hips, whether both legs are included in the cast, and how wide the legs are spread vary depending on what your doctor is treating. The list below is meant to be used as a guide. 

Not all the tips below will work for every child. It is important to keep trying other positions, ways to put on the diaper, and cleaning methods until you find one that works best for you and your family. Taking care of this cast can be a challenge.

Do not leave your child alone. He will be unable to catch himself if he falls from a bed, chair or pillow. 


Always keep the head and upper body elevated above the cast. This will help to decrease the chance stool or urine will leak into the cast. Your child may lie flat for diaper changes if needed. 

Some children prefer

  • A bean bag chair

  • A Boppy pillow

  • A recliner

You need to change the position of your child every 2 hours during the day and every 3-4 hours at night to prevent skin issues. This can be done at the time of diaper changes. Turn your child on his/her back, sides and stomach. Place a rolled towel or pillow under their calf or shin when laying on their back or stomach to take pressure off their heels and toes.


It is crucial when picking up or carrying your child that you always support the cast from the bottom with your arm under both legs. Do not pick your child up from under his armpits. 

Before you leave the hospital someone will help you decide if your current car seat or booster seat will work with this cast. If not, a different car seat or harness will be ordered while your child is in the hospital. Most items can be rented. 

Diapers and/or Toilet

Changing diapers and preventing leaks can be a challenge. We suggest using a three-layer method. The first layer is a thick maxi pad. It should be tucked into the diaper area, from front to back, to fill the opening in the bottom of the cast. The second layer is a very small diaper. It is also tucked inside the cast over the maxi pad. The third layer, or outer layer, is a large diaper that fits over the cast. We suggest using one that is 2 sizes larger. Change the inner pad and diaper every 1-2 hours during the day and every 3-4 hours at night. If your child uses the toilet, you may use a bedside commode, bedpan or urinal.

Skin Care

Skin problems are common in children with a hip spica cast. Keeping the cast clean and dry and moving your child often will help prevent issues. Check your child’s skin during diaper changes. A flashlight can be used to help see inside the cast. If redness is seen, keep the area dry and open to the air. 


Small, frequent meals are best. Large meals may upset your child’s stomach.

Do not make changes to your child’s diet or add new foods as this could cause stomach upset and diarrhea. Have your child eat plenty of fresh fruits and vegetables as well as whole grain foods to prevent constipation. 

When to Call

If redness is seen, keep the area dry and open to the air. Call the clinic. You may need ointment or medicine. 

Who to Call

If you have any questions, please call our clinic.

Pediatric Orthopedic Clinic: 

(608) 263-6420 (Monday through Friday 8:00 am - 4:30 pm). After hours and on weekends, this number will be answered by the paging operator. Ask for the orthopedic resident on call. Leave your name and phone number with the area code. The doctor will call you back.

If you live out of the area call: 1-800-323-8942.

If you are a patient receiving care at UnityPoint – Meriter, Swedish American or a health system outside of UW Health, please use the phone numbers provided in your discharge instructions for any questions or concerns.