Cast Care

What is a cast?

A cast is a hard splint that completely encloses part of an injured arm or leg in the best position for healing. The purpose of a cast is to prevent all movement and protect a broken bone or torn ligament until it heals. The inner layer of a cast is cotton padding to protect the skin. The cast itself can be made out of plaster or fiberglass.

How can I take care of my child?

• Elevation. If the leg is injured, elevate the leg on pillows for at least the first 24 hours. This will limit the amount of swelling that occurs. If the arm is injured, your child should wear the sling provided by your healthcare provider to keep the injured part elevated above the heart and limit swelling. Occasional wiggling of the fingers or toes will also prevent some swelling.
• Pain Relief. Give acetaminophen or ibuprofen in the appropriate dosage for pain. Continue this for at least the first 48 hours.
• Dryness. Don't get the cast wet. Wet plaster can become soft and crumble. Wet padding under a fiberglass cast can cause skin rashes. If the cast becomes wet, dry it with a hair dryer. To keep from getting the cast wet, use a washcloth and wash basin to bathe. Always cover the cast with a plastic wrapping to protect it when you are going to be around water, even when it is raining. Enclosing the cast in a plastic bag for a bath or shower usually doesn't work. Do not put any powders or lotions inside the cast.
• Skin care. Don't stick anything down into the cast, such as a coat hanger or other device, to scratch an itch. It might injure the skin and cause an infection.
• Walking. If the cast is on a leg, don't let your child walk on it unless you have your healthcare provider's approval. Never walk on it the first 48 hours because it takes that long to completely dry and become strong. If your child was given crutches or a walker, that means your child should not put any body weight on the cast when walking.
• Activities. Children with casts can go to school and play. However, they need to avoid riding a bike or playing any hard sports. The reason for this is that if the cast breaks, it may make the original injury much worse. Avoid swimming and other activities that might get the cast wet.

What are the signs of a tight cast?

If the cast is too tight, it can decrease circulation in the fingers and toes. The most common symptoms of a cast that is too tight are the following:

• Your child feels numbness, tingling, or increased pain.
• The fingers or toes turn to a different color (pale or bluish) than the color of the fingers or toes of the noninjured arm or leg.
• The fingers and toes become swollen.

When does my child need to be seen again?

Most children who have a cast need close follow-up.

When should I call my child's healthcare provider?

Call IMMEDIATELY if:

• Your child feels numbness, tingling, or increased pain.
• The fingers or toes turn a different color (pale or bluish) than the color of the fingers or toes of the noninjured arm or leg.
• The fingers and toes become swollen.
• Your child has trouble moving the fingers and toes of the arm or leg that has a cast on it.
• Pain under the cast becomes severe and pain medicines do not help.
• Any drainage comes through or out of the end of the cast.
• A bad odor comes from underneath the cast.
• You notice a stain or area of warmth on the cast.
• Your child develops a fever.
• The cast feels too loose or too tight.
• The cast becomes soft or breaks.
• You have a fiberglass cast that doesn't feel dry in 4 or 5 hours after getting it wet.
• You have a plaster cast and it gets wet.