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Casting and Splinting Care and Management

Care and Management

Your new cast or splint will be dry enough to leave the office, but fiberglass may take up to 1 day and plaster may take up to 2 days to fully cure.

  • During this period, you do not want to put any constant pressure or weight on your cast. It could easily bend and lose its shape.
  • In cases where weight is permitted by your Doctor:
    - Sit for about 10 minutes after application to let it harden. A cast shoe will be provided for you.
    - Minimal walking only, within the first hour of application is permitted.
    - After that, walking should still be limited from your normal routine. Too much walking can break the cast down and wither the cotton. This leads to rubbing in the cast.
    - Walking should only be done in a cast shoe. Walking directly on the cast is not permitted.
  • Dry skin under the cast will occur and may cause itching. Do NOT put any objects inside cast to scratch.
  • You may blow air down cast by using a hairdryer, on the cool setting, to relieve itching.
  • Rubbing skin above the cast or placing ice packs over the itchy area may also help.
  • Over-the-counter Benadryl can also relieve itching, but may also cause drowsiness.
  • There is little you can do about the odor. Perfumes, powders, Febreeze, etc. are not recommended. They can irritate the skin and make the odor worse.
  • Protect foot with a plastic bag or large sock when going outside.
  • Traditional cast padding is a cotton material that absorbs water and perspiration which often causes itching and odor.

Do NOT submerge the cast or splint in the water for any reason.  Wet casts lose strength, are uncomfortable, and may cause skin irritation or sores.

How to Keep the Cast Dry

  • For showering or bathing, wrap a towel around the cast and then cover the cast with a heavy grade trash bag.
  • Make sure the towel and bag are longer than the cast. Gather the top of the trash bag to one side and make a knot with the excess plastic.
  • Secure with a rubber band or tape.
  • Cover the bag by wrapping Saran wrap or Press and Seal around the cast.
  • Using wide waterproof tape, tape around the top of the cast with overlapping layers.
  • Tape the top of the plastic cover to seal the cast. Then saran wrap at each end of cast and put a plastic bag over the cast and hang the arm/leg outside the tub/shower.
  • Do not place tape directly on the skin.
  • When using this method, it is best to keep the water around the cast limited and do not fully submerge the cast in water.
  • Waterproof cast covers are available for purchase at Washington University Orthopedics or at medical supply stores and pharmacies.

If the cast becomes saturated, please call our office at (314) 514-3500.

Pain Management

Some pain around the fracture site is to be expected. To help decrease the pain and swelling after injury:

  • Remember to keep your arm/leg elevated above the heart when sitting or lying down.
  • Apply ice packs over the fracture site. This will help minimize the pain. Wrap the ice packs in cloth and plastic so the splint/cast does not get wet.
  • Wiggle the fingers/toes ten times per hour. This will help to decrease swelling and prevent stiffness.
  • Use prescription (if applicable) or over-the-counter medications such as acetaminophen, ibuprofen, or Naprosyn.

CALL THE PHYSICIAN/EXCHANGE IF:

  • The fingers/toes on the immobilized arm/leg have a different color from those on the other arm/leg (i.e. pale or white, purple or bluish, or the pink color does not return quickly after pressing the toes or finger tips).
  • There is enough swelling to make the cast/splint rub or feel too tight. Some swelling is expected. Please elevate the extremity.
  • The immobilized arm/leg is colder than the other ones.
  • There is numbness, tingling, or a pins and needles sensation that is not alieved by elevation.
  • The cast/splint becomes too loose and the arm/leg moves around inside of it.
  • There is a strong odor from the immobilized limb.
  • Drainage or discoloration is seen on the cast/splint.
  • The cast/splint has broken or becomes very wet.
  • Any objects become lodged inside the cast/splint.
  • The patient has a temperature of 101.0 degrees or higher.
  • There is severe pain even after medication is taken; especially with movement of fingers/toes.


 

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