Complications of Hip Spica 10-12-11

COMPLICATIONS OF HIP SPICA

Presentation by

DR. MOHSIN BILALREGISTRAR

DEPARTMENT OF ORTHOPEDIC SURGERY

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

1 Swelling2 Allergic Reaction and contact

dermatitis3 Pressure sores4 Cast syndrome5 Shortening6 Angulations7 Disuse atrophy and Muscle

weakness8 joint stiffness9 Malunion10 Infections

COMPLICATIONS OF HIP SPICA

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 x- ray.

Acceptable Shortening Age Shortening

Birth – 02 years 15 mm

2 - 5 years 20 mm

6 – 10 years 15 mm

11 years – maturity 10 mm

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 Angulations Age Varus / Valgus Anterior/Posterior

Birth – 2 years 30 degree 30 degree

2 – 5 years 15 degree 20 degree

6 – 10 years 10 degree 15 degree

11 years – maturity

5 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 recovery.

8-JOINT STIFFNESS

9- MALUNION

10-INFECTIONS

THANKS