Casts and splints provide limb support after a fracture or surgery. They may also be used to stretch the muscles in a limb. The cast or splint keeps the arm or leg in the proper position and prevents or reduces movement.
Casts and splints are made either of plaster or fiberglass. They are molded to the limb (arm or leg), and cover a large area. They are used to immobilize part of the limb. Both plaster and fiberglass harden in three to five minutes, but plaster is not completely dry or hard for 24 to 72 hours. During this period the plaster might break or dent, so use extreme caution. Protecting the cast from damage, dirt and moisture may be hard to do, especially with very young children. But it’s important to keep the cast as clean and dry as possible.
Keep the cast dry.
Protecting a cast from moisture is difficult because bathing is part of a daily routine, and we can’t predict changes in the weather. If your cast is made of plaster, it will soften when wet and will not maintain proper support during healing. Fiberglass casts do not soften when wet; however, the padding inside the cast will retain moisture, become foul smelling, and may cause skin irritations. It’s best to take sponge baths rather than bathing in the tub or taking a shower. If the cast becomes wet, contact the Outpatient Clinic.
Keep the cast clean.
It is OK to draw or write on the cast with a permanent pen or marker.
Avoid sandboxes or playgrounds.
Getting sand or gravel under the cast can cause skin breakdown and irritation.
Check the cast regularly for unusual odors.
Check daily to ensure that the cast is not too tight or too loose. A cast that has become too tight could limit the blood supply to the limb or damage nerves.
Observe fingers and toes.
- Toes and fingers in the cast should stay pink and feel warm to the touch. To test for proper blood circulation, apply pressure to the fingernail or toenail. The nail should turn pink within about one or two seconds after the pressure is released. There should be no numbness, tingling or pain.
- You should be able to move fingers and toes. (Compare current motion to motion you had before the cast was applied.)
- Do not use anything to scratch under the cast. Scratching might break the skin and cause infection. It also might shift padding, leading to pressure sores.
- Keep foreign objects such as sand, coins, pencils, small toys, or food out of the cast.
- Do not push anything under the edges of the cast to pad it. If rough edges exist, they should be “petaled” to prevent skin irritation.
- Place a towel roll or small pillow under the ankle to prevent pressure on the heel when you’re on your back.
- Swelling in a cast is common, especially after surgery. To minimize discomfort and relieve swelling during healing, elevate your arm or leg as often as possible and apply ice (in a waterproof bag) over the cast or exposed areas of the limb. If the swelling does not decrease, notify your doctor or nurse immediately.
When and What to Report to Your Doctor
Cast problems, particularly those affecting movement, sensation, and/or circulation of the limb, are serious since permanent damage to the limb can occur in a short period of time. Seek immediate help if any of the following conditions are present.
- A new stain on the cast coming from inside the cast
- Any unusual or foul odor from the cast (perspiration odor from the cast is normal)
- Excessive irritability for no apparent reason
- Changes in color or temperature in the toes or fingers
- Increased swelling, tingling, pain or numbness in the fingers or toes that is not relieved by elevating the limb
- Skin irritations or rashes
- Toes that appear to have slipped back into the cast
- A cast that feels too tight or too loose (movement of the cast up or down)
- Cracking of the cast that allows movement
- Pain that continues and cannot be resolved with prescribed medicine
- Inability to move fingers or toes, or changes in amount of finger or toe movement
- Painful rubbing or burning inside cast
- The cast gets wet.
- Unexplained fever of 101.5° or greater
- A foreign object inside the cast
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This information is for educational purposes only. It is not intended to replace the advice of your health care providers. If you have any questions, talk with your doctor or others on your health care team. If you are a Gillette patient with urgent questions or concerns, please contact Telehealth Nursing at 651-229-3890.