Casts are commonly used to immobilise a limb after an accident or surgery to protect the injured area while it heals. Although a cast is strong, the following guidelines will help keep it in good condition, aid the healing process and maximise the benefits of the cast.
Check sensation and circulation:
- Make sure the cast is not too tight and that blood can flow well around the cast. Every eight hours, or more often if needed, be sure to check:
- Ensure movement of toes and fingers. Have your child move or wiggle his/her fingers or toes at least four times an hour throughout the day.
- Sensation (feeling): Touch the area above and below the cast several times a day. Call your child’s doctor right away if your child complains of numbness, tingling or pain.
- Blood flow (circulation): Press briefly on your child’s middle fingernail or large toenail several times a day. When it turns white, let go. If pink color does not return in 3 seconds, call your child’s doctor right away.
- Temperature: If your child’s hand or foot is cold, cover it with a blanket or sock or raise it above the level of the heart. Check it again in 20 min- utes. If it is still cold, check feeling and blood flow. If you think there may be a problem, call your child’s doctor right away.
- Severe swelling: Look for swelling above and below the cast several times each day. A little swelling is normal, but a lot of swelling is not. Compare the limb with the cast to the other one. If there is swelling, raise it higher than the level of the heart for one hour. Call your child’s doctor if the swelling does not go down.
- Keep the injured limb raised above the level of your child’s heart for 48 hours after the injury or if swelling persists. For example, elevate an arm in a sling or rest a leg on pillows.
- Regularly exercise fingers/toes with full range of movement to promote blood flow and reduce swelling.
- Exercise arms in slings regularly — remove the sling hourly during the day to exercise the elbow and shoulder and prevent stiffness.
- Learn how to use crutches — for leg casts, it is im- portant that crutches can be used properly to avoid a fall or further injury.
- Take care of the skin — keep an eye on the condi- tion of skin around the cast area, take note of any redness or deterioration.
- Use pain relief — a mild analgesia (i.e. paracete- mol/ibuprofen) may be used directed by clinician.
- Attend follow up appointments — it is important to keep any follow up appointments.
- Get the cast wet—this will degrade the plaster and reduce its effectiveness. cover it with plastic dur- ing showering or bathing. Make sure it is sealed as tightly as possible.
- Alter the cast — don’t trim, rearrange or remove any part of the cast, including the lining.
- Place additional lining in or around the cast —the plaster should be handled as little as possible.
- Insert objects—rulers, pencils or other objects must be kept out of the cast as this may damage the plaster or cause further injury.
- Use oils — do not expose the cast to oils, oil-based lotions or powders.
- Take part in any vigorous activity — especially if it involves the damaged limb/cast area.
- Play in sandpits or loose dirt — this could get into the cast and cause irritation or discomfort.
Seek medical advice if
- You should see your doctor or go to the nearest hospital emergency department straight away if you have:
- Your child experiences pain despite taking painkillers
- Fingers or toes of the affected limb that go white or blue and do not pink up with elevation
- Fingers or toes that won’t move
- Pain on moving your fingers or toes
- Numbness or pins and needles
- Any concerns about your plaster cast.
- Your child develops a high temperature.
- Your child experiences numbness or persistent tingling in or around the cast area.
- A blister or sore develops inside the cast.
- You can smell unusual odours coming from the cast area.
- The cast becomes very dirty or wet.
- Your child’s cast breaks, cracks or develops soft spots.
- If the cast becomes loose and starts to move around.
- You notice your child developing skin problems at the cast edges.
Orthopaedic Outpatients Department
Level 1, Lady Cilento Children’s Hospital
501 Stanley Street, South Brisbane
t: 07 3068 2579
t: 07 3068 1111
In an emergency, always call 000.
If it’s not an emergency but you have any concerns, contact 13 Health (13 43 2584). Qualified staff will give you advice on who to talk to and how quickly you should do it. You can phone 24 hours a day, seven days a week.