Cast Care Instructions

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 from plaster or fiberglass.

How can I take care of my child’s cast?

• 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 hrs. Get expert advice from CHOC on acetaminophen and ibuprofen dosage.
• Dryness. Don’t get the cast wet. Wet plaster can become soft and crumble. Wet padding under a fiberglass cast causes skin rashes. If the cast becomes wet, dry it with a hair dryer on cool. 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. Follow instructions provided for putting weight on broken leg.
• Activities. Children with casts can go to school. However, they need to avoid running, jumping, sports and riding a bike or scooter. 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.
• Foul-smelling cast. A cast will not be changed due to a foul smell. It is common for the cast to smell badly because the area it covers cannot be washed. Do not apply powder or perfume inside or on the cast. Doing this will not help removed the smell and may cause skin irritation.

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 blush) than the color of the fingers or toes of the non-injured arm or leg.
• Swelling of the toes or fingers.

When should I call my child’s healthcare provider?

• Your child feels numbness, tingling, or increased pain.
• The fingers or toes turn a different color (pale or blush) than the color of the fingers or toes of the non-injured arm or leg.
• The fingers or toes become swollen.
• Your child has trouble moving the finger of the arm or toes of the leg that has a cast on.
• 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.

Who should I call?

Please call the orthopedic nurse line at (714) 509-8402. A nurse will respond to your call as soon as possible, within 24 hours, Monday through Friday, 8 am- 4:30 pm. If after hours, a weekend or holiday, the CHOC Emergency Department is available.

Who do I call for appointments or questions?

Please call the Patient Access Center for appointments or questions at 1-888-770-2462.

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