Erin was diagnosed with hip dysplasia (also called DDH) at 19 months old. She has had a number of operations to fix her hip including a closed reduction, open reduction and lastly a pelvic osteotomy. Following each operation, Erin has been fitted with a body cast called a hip spica cast.
A hip spica cast is a solid cast like you have after breaking a bone. A hip spica body cast goes from the belly area, over the lower torso, leaving a hole for toileting and then goes down the legs to the ankles. Sometimes the surgeon may finish at the knee on the side of the non operated hip. In our case, all the spica casts were full length going to the ankles. Many surgeons will also add a bar across at the knees to reinforce the cast and make it stronger, especially in children who will still try to be mobile.
You can read what are signs and syptoms of DDH in this post.
Back in a Hip Spica
After lasts weeks disaster things have settled down on the spica front. Erin has a resigned acceptance of her body cast once again, the only tough call was when she was hot and asked me to take it off so we could go swimming. Swimming is Erin’s main love and it pains us all that she can’t get in the water – but it is only four more weeks.
Erin is finding things a little boring this time and needs a bit more entertainment. I have to remember that she is six months older than the first time she went into spica and she has developed an awful lot in that time. A 2 1/2 yr old is programmed to be active and especially at this time of year, most are in the garden and enjoy being active but our kids in spica don’t have the same freedoms.
I always knew that time in this spica cast would go quite swiftly and so far it has. We are one third of the way down already. Erin had an extra X-Ray last Monday and it was great to hear that the wound was healing well and the bones still look like they are in the same position. It is the six-week post cast that will tell us whether everything has held following the salter’s osteotomy.
How to entertain children in hip spica body cast
I am often asked how we keep Erin entertained in the spica cast. In fact, when a child is diagnosed with DDH the first thought is what are they going to do with a toddler stuck in a spica. Many parents are worried that their child will be very unhappy and frustrated in the body cast.
However, truth be told the worst part is the waiting and fear before life in spica cast. Our hip kids are very resilient and most manage exceptionally well. In my experience, the whole thing is worst for parents who overthink and (rightly) worry because we have no experience of caring for a young child who is restricted by the spica.
Activities that have worked for us
We have been doing lots of Montessori learning at home.
- We spend days watching far too much TV! Mr Tumble on repeat is Erin’s preferred choice! There really is no such thing as too much TV for a child in spica!
- We also do lots of puzzles and her fine motor skills are brilliant. I am sure this is the reason Erin can count so well. Also, time is spent painting and today we will be making her daddy his birthday card. I have even considered getting her to make some Christmas cards as we have the time!
- Yesterday we made bead bracelets which Erin enjoyed. Obviously, this was a bit tricky and she needed help but she loved the finished result.
- Baking is always a popular option and now I have started getting her involved in making lunch it takes up another hour of our day!! She helps butter bread and make sandwiches, or decorate a pitta bread and turn it into a pizza. Preparing a fruit salad is also good and we talk about the different fruits.
- We go out walking and the local park does have a swing that Erin can get in. Its is a huge round one, like a dish. Many parks are more accessible now and she enjoys this when it’s not too hot or cold.
- Finally, I use the Ipad with Erin, it has some fantastic apps like the classic Ladybird books which she uses. I am really interested in how the Ipad is used with preschoolers. Many believe the kit is too expensive for young children and do not let them use it. Whilst I agree that you have to be prepared for an accident there is much research about how the Ipad has been beneficial for children with Autism and other learning disabilities as it is easy to use whether to play chess and do puzzles, read stories online or learn new things.
I hope these suggestions give other hip spica cast mums and dads some new ideas. It can be a long day and at the moment I have to choose between Erin having a daytime nap but then not going to bed until 9ish or keeping her up all day and she goes to bed at 7pm. This is due to her being so restricted physically that she doesn’t tire out like a typical 2 1/2 year old.
Some of these ideas will work for a child with a sensory processing disorder also.
