Cast Care - Trauma
The purpose of your cast is to keep your injury from moving so there is less pain and to promote healing. Most casts are made of fiberglass. Splints have the same goals, but allow more room for swelling just after an injury happens. Most splints are made of plaster.
What should I expect when the cast is put on?
Stockinette, a sock-like material, will be put over your injured limb. Stockinette is used to provide a cushioned finished edge to your cast. Next a soft cotton material (Webril®) is wrapped in layers around the Stockinette. Gauze rolls of fiberglass or plaster are then applied and molded to the shape of your injured limb. The casting material will begin to feel warm as it is put on. For the cast to harden, a chemical reaction occurs that results in the warmth you feel. This warmth will not burn your skin. No matter what material is used for your cast, it will harden and set in 5 to 10 minutes.
How do I care for my cast?
- Avoid getting your cast wet. The cast material may soften and weaken or come apart. The cotton under the cast is very hard to get dry. Wet Stockinette or padding can cause your skin to breakdown. If your cast gets wet, use a hair dryer on low setting to dry your cast. Do not hold the dryer in one spot too long or it will burn the skin. If the cast is saturated, contact the orthopedic clinic to arrange for a cast change right away.
- We strongly suggest that you take sponge baths while you are wearing a cast or splint. If you are allowed to shower or take a bath, use a plastic bag placed over your cast to help keep your cast dry. The plastic needs to be tightly secured above the cast. You may try double bagging the cast for extra protection
- Do not rest your cast in one position against hard surfaces for longer than 30 minutes because pressure can occur and your skin may breakdown.
- Raise your injured limb above the level of your heart as much as possible. This will help to reduce the swelling and pain in the first few days. Use pillows to prop your limb. Do not rest or prop your leg on your heel. This helps to prevent heel sores. If possible, try to keep your cast raise even while you sleep.
- Apply ice for the first 48 - 72 hours after your cast is applied. Loosely wrap an ice pack wrapped in a thin towel around your cast. Apply ice to the cast - not the skin - for 20 minutes every 2 hours while you are awake. This helps to prevent swelling.
- Do not scratch under the cast with any sharp object. This may cause skin irritation or sores you cannot see. Use an oversized sock as a toe warmer or mitten.
- Wiggle your fingers and toes. Exercise increases your circulation. This will help reduce swelling and promote healing. It will not harm or change your fracture.
- If you have rough edges on your cast, use a nail file to file them away or pad the edges with moleskin.
- Use a fan or hair dryer, set on cool, to keep your cast dry and comfortable. It will also help relieve itching.
What warning signs should I watch for?
- Numbness or tingling, cold or blueness or extreme paleness of fingers or toes. If this occurs, elevate your injured limb. If there is no improvement, call the doctor.
- Extreme pain. If this occurs, call your doctor right away.
- Swelling of your injured limb that makes your cast feel too tight. If swelling occurs, raise that part to the level of your heart. Put an ice bag over the cast. Make sure the ice bag is wrapped in a towel to protect the cast from wetness. It is normal for your injured arm or leg to swell when it is hanging below the level of your heart, but raising it should improve this.
- Loss of movement in your fingers or toes. Wiggle your toes and fingers to check them.
- Loose fit that allows the cast to slide around. A loose cast can cause skin irritation. Call your doctor.
- Breakage or damage to your cast. If your cast is damaged, keep your injured part as still as possible. Call the doctor right away.
What should I expect when the cast is taken off?
Your cast will be taken off with a special saw. It has a vibrating blade that moves back and forth rather than spinning. The saw is attached to a vacuum cleaner that sucks up the dust. You will only feel some vibration and pressure from the movement of the saw. After the cast is taken off, expect your injured limb to look smaller because your muscles were not used. Expect your skin to be dry and flaky. Use a skin lotion or bath oil to soften and remove dead skin once you are allowed to bathe. If you have an incision, don't use lotion or bath oil near it.
Monday-Friday, 8:00-4:30 p.m., Orthopedic Clinic: (608) 263-7540.
Pediatric Orthopedic Clinic: (608) 263-6420
Nights and weekends, either number will give you the paging operator. Ask for the orthopedic resident on call. Leave your name and phone number with the area code. The doctor will call you back.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 08/21/2013
Copyright © 08/21/2013 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7075
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