Cast Care at Home

A cast is placed on a broken bone to protect the extremity while it heals. It is made of plaster of fiberglass.

CARING FOR YOUR CAST WILL:

• prevent breaking down of the cast.
• keep skin under the cast from becoming infected or scarred.
• protect the injured arm or leg until the bone is healed.

INSTRUCTIONS FOR CAST CARE:

Elevate the extremity for the first 24-48 hours to help prevent swelling.

Only walk or bear weight on the extremity if approved by your physician.

DO NOT GET THE CAST WET!

• BATHING: DO NOT get in the shower with a plastic bag over your cast; at some point the bag will leak and the cast will get wet!
• Bathe in a bathtub. A bag over the arm or leg held out of the water should keep the cast from getting
  splashed.
• DO NOT walk in water.
• ALWAYS wear cast shoe when walking. Cover the cast before putting on the cast shoe if it is raining outside. Remove the cast shoe only for bathing or sleeping.

DO NOT allow your child to insert objects inside the cast to scratch the itch.

• ITCHING: Perspiration (sweat) exercise and heat will cause the skin under the cast to itch. Keep the cast/skin CLEAN, COOL AND DRY!
• DO KNOCK OR TAP ON CAST WITH WOODEN SPOON OR HAND. Vibration inside the cast will ease itching.
• DO blow cool air inside cast with a blow dryer. IT MUST BE ON COOL SETTING! Warm air will tend to burn the skin under the cast.
• DO TAKE BENADRYL by mouth for itching, if ordered by your physician, when the above steps are not sufficient. This medicine can be obtained over the counter at any grocery or drug store.
• DO NOT put powder into the cast.

AVOID SAND, DIRT AND MULCH!

DO NOT PULL COTTON LINING OUT OF CAST.

This lining protects the skin from the cast saw blade when the cast is being removed. If the lining is pulled out and removed, the skin may get scratched during
cast removal.

RESTRICT ACTIVITIES UNTIL THE BONE IS HEALED.

Once a bone is broken, it needs to be rested in order to heal properly. Walking or using an arm or hand as a helper is OK, if approved by your physician, BUT RUNNING, JUMPING, CLIMBING, and SPORTS ARE OFF LIMITS DURING HEALING. Movement across a fracture (break) in the bone can cause it to take longer to heal, to heal poorly with scar tissue and not bone, or not heal at all! It is very important to try to rest the arm or leg until it heals completely. Once healing is complete, full activities may be resumed as instructed by your physician.

CALL THE PHYSICIAN IMMEDIATELY IF:

• New pain develops after healing has begun or does not respond to pain medications.
• Numbness or tingling occurs and will not stop.
• Toes or fingers turn blue (pushing on the nail should turn color from white to pink within 3-5 seconds after releasing)
• The fingers or toes become swollen.
• Your child has difficulty moving the fingers and toes of the casted arm or leg.
• Drainage comes through or out of the end of the cast.
• A bad odor comes from underneath the cast.
• A stain or area of warmth develops on the cast.
• Your child develops a fever.
• The cast feels too loose or too tight.
• The cast becomes soft or broken.
• You have a fiberglass cast that does not feel dry after 4-5 hours after getting wet.
• Something is stuck in the cast.
• Sand or dirt gets in the cast.

AFTER THE CAST IS REMOVED:

• Swelling of the limb is expected for 1-2 weeks after cast removal. This will resolve as muscles regain strength. 
• After removal of a leg cast, it is common for children to walk with their foot turned outward for several weeks. This, too, will improve as the muscles regain strength and coordination.