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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