How to apply a walking one-legged hip spica cast -paediatrics trauma- educational video for surgeons

Join UK Consultant Paediatric Orthopaedic Surgeon and Paedipods podcast host Pranai Buddhdev talking us through how to apply a walking, one-legged hip spica for paeds femur fracture.
Low energy, paediatric femur fractures in the 1-6 year age group are traditionally treated with a hip spica, which has proven reliable and safe over the years. However, because both legs get immobilised, the regular hip spica is very restrictive and makes life pretty tough for the kid and their family for the 6-weeks or so that it stays on for.
The child has to be carried around and helped to transfer etc, which makes the whole caring role pretty intensive, not to mention managing toileting, hygiene and skin/pressure problems.
The walking, one-legged hip spica is an elegant adaptation and it’s not all that different from a regular hip spica to apply. It allows immediate weight-bearing and transfers on the unaffected side. Then, by the 2-3 week mark, the kids can even walk on the fractured side (we’ve got videos showing it!).
So by the time it comes off at 4-6 weeks, they’re already walking around and smashing it up! Reduced analgesic requirements; shorter length of stay; fewer skin pressure areas; reduced burden on the caregivers. It’s a no brainer!
Pranai talks us through applying one of these spicas; including all the tips, tricks and avoiding pitfalls; little nuances on where to strengthen it and where to allow movement; and even where to put the sparkles at the end!
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Founded by a group of orthopaedic surgeons, orthohub provides free innovative interactive orthopaedic education for all. At orthohub we want to shape the future of orthopaedic education through learning how and why decisions are made and the tips and tricks of operating. The art of surgery is more than just knowing how to do something, it's knowing the simple steps that make for better results. Learn more about orthohub at orthohub.xyz/.

[@orthorules1580]

Nice video, very informative. If I may add, all the bandages, cotton, the cast materials should be applied from a distal to the proximal direction. Thanks!!

[@kashakhtar8190]

Fantastic work Pranai, almost makes me want to go and get a British Casting Certificate

[@gavinsylvester3409]

Really good video thanks not applied one of these for a long time so it was a very useful tutorial thanks very much

[@MrMbarry]

It’s a shame that Mr Buddhdev didn’t introduce his assistant and confirm that the assistant should be a trained casting technician and in the UK, a BCC (British Casting Certificate) holder.

[@kashakhtar8190]

Behave Mr M Barry (and hello!)

[@MrMbarry]

@@kashakhtar8190 Hello Kash! I always stick up for casting techs and promote their training. As chair of the BOA casting committee, that’s what I do!

[@ashualain2848]

Can a hip spica be remove before 3 weeks for children??

[@michaelalfons4418]

Great video can you please share a link where I can get this spica table

[@urbanexplorer1754]

Can same technique be applied for Plaster of paris bandages or that needs traditional one and half spica due to its weakness as compared to fibrecast?

[@opolonos]

4-6 weeks starting from fracture date ? the cast is applied since day 1 from the fracture ?