Comfort and Ease of Care in Pediatric Hip Spica Casts: A Comparison of Fiberglass Versus Plaster of Paris.

Abstract

BACKGROUND: Pediatric patients with femur fractures or those undergoing pelvic surgery for dysplasia or dislocation require immobilization with a spica cast to maintain reduction, protect the correction, and ensure adequate rehabilitation. Materials used for immobilization include plaster of Paris (POP) and fiberglass casts. The study objective is to compare fiberglass spica cast immobilization with plaster of Paris in terms of comfort and ease of care. METHODS: A prospective cohort study comparing the comfort and ease of care of pediatric patients immobilized with a spica cast POP and fiberglass was conducted, encompassing patients treated between 2022 and 2025. Outcomes were assessed using an observer-rated outcome (ObsRO) questionnaire adapted from the one described by Inglis and colleagues, and the correlation between the ObsRO score and the constructs of comfort and ease of care was assessed using Pearson correlation coefficient. In addition, complication rates and cast modifications by spica material were reported. RESULTS: The median ObsRO questionnaire score was higher for fiberglass than for POP (P<0.001). The Pearson correlation matrix between this questionnaire and the constructs for validity yielded 0.59 and 0.63 for comfort and ease of care, respectively. There was no statistically significant difference in adverse events related to each material. CONCLUSIONS: The fiberglass pelvic spica cast is more comfortable and easier to care for than plaster of Paris in immobilized pediatric patients. There were no differences in complication rates between the 2 materials. LEVEL OF EVIDENCE: Level II.