Your surgeon will have told you that a hip spica or broomstick cast may be required for a period of a few weeks (around six weeks usually) following your child’s surgery. Sometimes after operations to hold a broken bone in place such as the thigh bone (the femur) or after a procedure to put a dislocated hip back in place, surgeons like to ‘protect’ their work by limiting the child’s movements by placing them in a hip spica or broomstick cast.
You should have received information regarding this surgery in clinic and a copy of the clinic letter describing it in detail. If you require another copy of this letter or have further questions then please contact the Catterall unit secretaries who can put you in contact with the team looking after you, or arrange a further outpatient appointment to clarify any concerns. The number can be found at the end of this webpage.
We have put together some information that we hope will prepare you for looking after your child in a hip spica or broomstick cast once you leave hospital. Spica and cast are the same thing and just mean plaster of paris. You should have been seen or been contacted by an Occupational Therapist (OT) or Clinical Nurse Specialist (CNS) prior to your admission, who should be able to answer any further questions or concerns you may have.
Depending on the size of your child, the Occupational Therapist will discuss different ways of moving your child, making sure you support the cast whilst protecting your back. For babies and smaller children who weigh less than 15kg in their cast you will be able to lift, carry and cuddle using the ‘scoop lift’. The Occupational Therapist or Clinical Nurse Specialist will show you how to do this. Where possible try to minimise the distances you have to carry your child, and use the buggy/wheelchair if possible. This will help protect your back. It is recommended that you do not lift a child over 15kg and therefore older children may need equipment to help move them. This equipment will be arranged before admission, by the Occupational Therapist. During admission the Occupational Therapist will see you on the ward and practise moving your child around safely and issue a wheelchair if s/he is unable to fit back into their own buggy. Please do not lift your child holding onto the bar that is in between your child’s legs keeping the legs apart.
It is unlikely that your child will be able to walk in their hip spica or broomstick cast so they will need to mobilise using a buggy or wheelchair. If your child is under about 3 years old you should bring your buggy into hospital with you on the day of your admission. A buggy with open sides and recline will be the most suitable. Please consider the weight limit of the buggy as the cast will add up to 2kg in weight. If your child is older it may be necessary to borrow a wheelchair which the Occupational Therapist will organise for you.
The plaster cast on your child following surgery will keep them in a safe and fixed position, which can sometimes make it difficult to position and fit them into a buggy or wheelchair. The Occupational Therapist will help you position your child in the buggy or wheelchair to ensure they are comfortable and safe.Children in hip spicas or broomstick casts should not be left in buggies or wheelchairs for long periods and should be repositioned regularly to avoid pressure areas. Also remember the plaster must not get wet so use a plastic rain cover if going out in wet weather.
It is important to change your child’s position frequently for comfort and to avoid any pressure areas developing. Plaster Theatre will advise you about plaster care and managing pressure areas. Your child can be positioned in a variety of positions using pillows and blankets to support. You will be shown how to do this during your stay.
It is important that the entire cast is supported to evenly distribute the pressure and weight of the cast. Always support the ankles off the bed or buggy for pressure relief by placing a small rolled towel or similar under each ankle.
If your child uses nappies or pads, the nursing staff will show you the double nappy technique once your child is in the hip spica. You will need to buy two different sized nappies – one smaller size to push inside the cast and one larger size to go over the cast. You may have to change nappies more frequently to avoid the cast becoming wet or soiled.
Children in broomstick casts may be able to slide transfer across onto a commode. The commode will be organised for you and the Occupational Therapist will practise this transfer with your child prior to discharge.
It is not usually possible to slide across onto a toilet in a hip spica or broomstick cast.
The hip spica or broomstick cast must not become wet so it will not be possible for your child to have a bath. A daily ‘top and tail’ wipe down with soap and a damp cloth or wet wipes is advised. This might be easier for you do with your child lying on a bed with a towel or waterproof protector underneath.
Hair washing can be done using a dry shampoo or a hair washing tray which you can buy online. The Occupational Therapist can advise you further about this.
Children in hip spicas can wear larger sized baby grows, dresses or t-shirts as these should fit over the plaster cast. Your child should be able to wear socks to keep warm. However, do not overheat your child as the cast will provide a layer of insulation. Children in broomstick casts can wear dresses or t-shirts for upper body and adapted pants or shorts for lower body. The Occupational Therapist or Clinical Nurse Specialist can give you more information about this.
Your child may not fit into their usual chair for feeding so you may need to find alternative ways to keep them upright while they eat. You can keep them upright on a bean bag or a buggy, depending on their size.
Small babies may sit on your lap to feed and if you are breast feeding, extra pillows may make this more comfortable for you both. Cover the cast with a towel, bib or long sleeved apron during feeding times to avoid accidental soiling.
For older children who cannot sit up in the cast try placing a pillow behind them to bring them up a little for feeding and ensure they eat small mouthfuls slowly whilst you are present.
Being in a spica cast does not restrict your child from eating the foods they normally would. However, be mindful they do not eat too much as they may become bloated and uncomfortable. Eating smaller meals more often may help to avoid this.
It is important to keep things as normal as possible for your child whilst in the spica cast and to think about ways of keeping them safe and occupied throughout the day. Return to previous routines where possible and encourage involvement in activities that they enjoy. If your child has a small teddy bear, plaster theatre will put a cast on the teddy to mimic the cast on your child as this sometimes helps children to accept that they need to stay in the cast for a few weeks. Bring the teddy in with you on your admission. If you think there is anything else that might help please let us know.
Babies can continue to spend time on a mat on the floor to develop their hand, arm and head skills. Children can also lie on their stomachs to play and stretch out for short periods of time as can be tolerated. Your nurse or Occupational Therapist can show you how to do this on your admission.
The Occupational Therapist or Nurse will discuss returning to nursery or school with you in further detail and can liaise with nursery or school as needed. Be prepared to be at home with your child if they are unable to return to school whilst in the cast.
Each child is cast in a different position following surgery, so it is not always possible to accurately predict whether children will fit into a car seat (if you have a car) following application of the hip spica cast or broomstick cast. For older children consideration also needs to be given to safely transferring from wheelchair or buggy to a car seat. We are unable to provide any specific advise on car seats and recommend you contact www.incarsafetycentre.co.uk or call 01908 220909. If you feel you will not be able to transport your child home safely in your own vehicle, please inform the ward nurse on your admission.
You can also contact the STEPS charity who may offer you further advice on positioning and caring for your child in a spica cast. If you feel you need further support that has not been
covered on this webpage or just want to chat to someone about any worries you may have please do not hesitate to call any of the numbers in the section below.
For any further questions about this leaflet you can contact:
Children’s Therapy Team
0208 909 5821
Clinical Nurse Specialist Team
0208 909 5409
Plaster Theatre
0208 909 5599
Catterral Unit
020 8909 575
Ref: 21-88 © RNOH
Date of next review: July 2026
Page last updated: 27 November 2025