Cast Care

Here are some basic guidelines to follow in regards to caring for your new cast.

Cast Material:

The outside of your cast is fiberglass. Fiberglass has replaced plaster in most office settings.  Fiberglass dries faster, is more durable, and comes in a variety of color choices.  The inside of your new cast is usually one of two types of material, either a soft cotton material or a waterproof material.  It is up to your individual practitioner to make the decision when it is acceptable to use the waterproof material.

Non-waterproof casts:

Keeping your regular cast dry is very important!  There are no devices that are 100% effective in keeping any cast dry.  Sponge baths are the safest way to keep the cast dry.  If you have to take a bath or shower, please follow these instructions:

• Place a towel or washcloth around the upper portion of the cast
• Cover the entire cast with a plastic bag
• Secure the bag at the top with tape or rubber band
• Dry the top or bottom of the cast if it gets moist with a blow dryer set to the cool setting
• If the cast is soaked all the way through, it needs to be changed and you should contact our office

Waterproof Casts:

If you are able to have a waterproof cast, then the cast is completely waterproof. You are allowed to submerge the cast in any amount of water.  You are free to bathe, shower and even swim, if that is okay with your doctor and your parents!  We generally do not put waterproof casts around ankles and elbows because skin irritation and pressure sores may develop in those areas.  We also do not use waterproof casts immediately after surgery because of the possibility of infection.

To make sure you waterproof cast stays clean, please run warm soapy water through the cast as needed.

General cast care for both waterproof and regular casts:

NEVER PUT ANYTHING INTO YOUR CAST!  There are two reasons for this.

1. Sticking a coat hanger, ruler, etc. into the cast can scratch the skin, which could lead to an infection
2. Whatever you stick in the cast can get stuck, also causing a skin irritation or infection

Please contact our office if something gets stuck in your cast.

How to manage swelling within the first couple of days of injury:

Swelling is greatest in the first 24-48 hours after the injury. To minimize swelling in your cast follow these simple instructions:

• Raise the cast above the level of the heart. 
  • Arm casts –It’s important to raise your hand above the elbow which should be above your heart .  If you just raise the elbow portion on pillows the hand is likely to swell.  A simple method is to lie down on your back with the arm out to your side and the fingers pointed up towards the ceiling.  
  • Leg casts –Lie down on your back with the leg propped up on approximately two pillows.  Again, the pillows should be under the calf and heel area, not just under the knee.
• Wiggle fingers or toes as tolerated
• Use your sling intermittently during the first 24-48 hours after injury.  Your arm and hand will be below the level of the heart in the sling and that can increase the initial swelling.
• Non-steroidal anti-inflammatory medications such as Motrin or Advil can be taken.  Take as directed on the bottle.  DISCONTINUE IF THIS CAUSES STOMACH UPSET!

If these methods fail, your cast may need to be split down the sides to allow for swelling to resolve.

Problems to watch for:

These things can be signs of problems in the cast and should any occur, you should contact our office immediately or go to the nearest emergency room.

• Unexplained fever
• Cast edges irritating the skin
• Foul odor or fluid coming from the cast
• Complaints of burning or rubbing inside the cast
• If toes or fingers become discolored, numb or painful with small movements
• If the cast is too loose
• If the toes or fingers swell approximately twice the size of the unaffected limb

 American Academy of Orthopaedic Surgeons Cast care site