COMPLICATIONS OF HIP SPICA

Presentation by DR. MOHSIN BILAL REGISTRAR

DEPARTMENT OF ORTHOPEDIC SURGERY

Hip
It

Spica

is a type of orthopedic cast used to immobilize the hip or thigh to facilitate the healing of injured hip joints or fracture femur.

COMPLICATIONS OF HIP SPICA

1 Swelling 2 Allergic Reaction and contact dermatitis 3 Pressure sores 4 Cast syndrome 5 Shortening 6 Angulations 7 Disuse atrophy and Muscle weakness 8 joint stiffness 9 Malunion 10 Infections

1- SWELLING
Edema, fluid that persists in the foot, can impede the synchrony of motion between tendons, bones, and joints. An extremity should be elevated and placed in traction until swelling reduces before placing it in a cast.

2- ALLERGIC REACTIONS AND CONTACT DERMATITIS

Diisocyanates are used in fiberglass casts. Allergic reactions, although temporary, have been reported Injury Due to Foreign Objects

3- PRESSURE SORES
The patient's complaints of a painful cast should never be ignored, and the cast should be changed promptly. Often, this may reveal an area of early skin pressure or irritation that could progress to full-thickness skin loss. These patients are particularly susceptible to thermal, pressure, and friction injury due to contact casts. Regular assessments of the casts and changes should be undertaken

4- CAST SYNDROME
The syndrome occurs due to arteriomesenteric duodenal obstruction, and it is a result of excessive abdomen and chest coverage. The symptoms are severe, and if left untreated, can be potentially lethal. There is a potential danger of compression of the third part of the duodenum between the lumbar spine and the aorta posteriorly and the mesentry and vessels anteriorly. This syndrome is precipitated by recumbency and increased lumbar lordosis. . Nausea, epigastric fullness, and regurgitation should be carefully evaluated

5-Shortening
Minimal

shortening is acceptable but should not exceed 2cm. This is best measured on a lateral xray.

Acceptable
Age Birth 02 years 2 - 5 years 6 10 years

Shortening Shortening
15 mm 20 mm 15 mm 10 mm

11 years maturity

6- Angulations
It

the follow up radiograph reveal significant varus more than 10 degree the cast may be wedged to within 5 to 10 degree of anatomical alignment in all planes. However weiss and associates noted that 90 degree /90 degree spica casts can cause peroneal nerve palsies. Especially during correction of valgus angulations.

Acceptable
Age Birth 2 years 2 5 years 6 10 years 11 years maturity

Angulations
30 degree 15 degree 10 degree 5 degree

Varus / Valgus

Anterior/Posteri or 30 degree 20 degree 15 degree 10 degree

7- DISUSE ATROPHY AND MUSCLE WEAKNESS

Muscles

that do not function when under cover of plaster can become atrophic. Not only can this result in cast loosening, but there may also be functional loss. Isometric exercises should be encouraged. Prolonged non weight-bearing treatment in a cast can also result in disuse osteopenia, which can complicate

8-JOINT STIFFNESS 9- MALUNION 10-INFECTIONS

THANKS