Casts and splints support and protect injured bones and soft tissue. When you break a bone, your doctor will put the pieces back together in the right position. The function of a cast is to rigidly protect and immobilize an injured bone or joint. It serves to hold the broken bone in proper alignment to prevent it from moving while it heals. Casts may also be used to help rest a bone or joint to relieve pain that is caused by moving it (such as when a severe sprain occurs, but no broken bones).
Cast care will help the cast dry and harden correctly, and then protect it until it comes off. Your cast may need up to 48 hours to dry and harden completely. Even after your cast hardens, it can be damaged.
At Ventura Orthopedics, our expert team wants to ensure that you know how to care for your cast to reduce the chance of re-injuring the break and to make sure the skin under the cast stays free of infection. We also care about your comfort. Below are some tips to help your recovery be as healthy and comfortable as possible.
What Are Casts and Splints?
Many orthopaedic injuries that occur will be initially treated with some form of temporary immobilization as this will be the most comfortable for the patient and will maintain stability for the injured area. Most often, splints and casts are used for the treatment of fractures (broken bones).
A splint is a typically temporary device that is used to treat an acute fracture. They can be pre-formed materials such as metal or rigid plastic that is covered in various cloth materials, or made out of fiberglass or plaster. These are designed differently than actual casts so that they can allow for the swelling to occur without risk of further complications. If an acute injury is treated with a rigid complete cast, risk of injury to the skin is high. There is also risk to the nerves and blood vessels under the cast from too much compression as the tissue expands from the swelling. For this reason, a splint is typically used as it functions as “a half cast” where areas are left free to swell naturally and safely. As the swelling process resolves, then this can be changed to a cast to allow more rigid support.
A cast is typically a fiberglass construct that can be molded specifically to the needs of the fracture and can be worn for several weeks as needed. This is more rigid than the temporary splint, but both may feel fairly heavy. Depending on the specific type of fracture, the splint or cast may be worn for anywhere from a few days to a few months. The purpose of the cast is to keep the bones in rigid alignment to allow the body to heal them over several weeks to months. Casts can realistically only be used if the bones are in the correct alignment for healing without complications, otherwise, other means such as surgery may be needed to achieve the correct and stable alignment.
Types of Casts
Casts are custom-made to fit and support injured limbs. There are two main types of casts:
- Plaster casts. Plaster casts are easier to mold for some uses than are fiberglass casts. Plaster casts are also generally less expensive.
- Fiberglass casts. These plastic casts are typically lighter and more durable than plaster casts. Also, X-rays penetrate fiberglass casts better than plaster casts — making it easier for your doctor to examine the bones while the cast is in use.
Care For a Cast or Splint
You must protect your cast from damage so it can protect your injury while it heals. If you have broken your foot or leg, you will probably get crutches to help you walk. A sling will help support your cast or splint if it is on your arm.
- Keep your splint or cast dry. Moisture can weaken it and it may not be able to keep your injured bone in place. Wet cotton padding next to your skin can cause a rash or other irritation. Use two layers of plastic or purchase waterproof shields to keep your splint or cast dry while you bathe and never submerge your cast in water, even if it is covered.
- Keep your splint or cast clean. Keep dirt, sand, and powder away from the inside of your splint or cast.
- Padding. Do not pull out the padding from your splint or cast.
- Itching. Do not stick objects inside the splint or cast to scratch itching skin. Do not squirt cream or anything else inside it to soothe the itch. In some cases, blowing cool air from a hand-held hair dryer into the cast may help relieve itching. If itching persists, talk to your doctor.
- Walking on casts. Do not walk on a walking cast until your doctor says it is safe. It takes time for casts to become hard enough to walk on. Using a cast shoe over your cast may prevent slipping.
- Inspect the skin around the cast. Contact your doctor if the skin becomes red or raw.
- Inspect your cast regularly. Contact your doctor if it becomes cracked or has soft spots.
- X-rays. Your doctor will probably schedule additional x-rays during your recovery to make sure your cast or splint is doing its job. X-rays can show whether the bones are healing well or have moved out of place.
Care For Your Cast While It Hardens
- Protect the cast. Do not put weight on the cast. Do not bend, lean on, or hit the cast with anything. Use the palms of your hands when you move the cast. Do not use your fingers. Your fingers may leave marks on the cast as it dries.
- Change positions often. You should change your position every 2 hours to help the cast dry faster. Prop your cast on something soft, such as a pillow, to prevent a flat area on your cast.
- Keep the cast dry. Tie plastic trash bags around your cast to keep it dry while you bathe. You may use a blow dryer on cool or the lowest heat setting to dry your cast if it gets wet. Do not use a high heat setting, because you may burn your skin. Certain casts can get wet. Ask if you have a waterproof cast.
Care For Your Cast After It Hardens
- Check your cast every day. Contact your healthcare provider if you notice any cracks, dents, holes, or flaking on your cast.
- Keep your cast clean and dry. Cover your cast with a towel when you eat. If your cast gets dirty, use a mild detergent and a damp washcloth to wipe off the outside of your cast. Continue to cover your cast with trash bags to keep it dry while you bathe.
- Keep weight off your cast. Do not let anyone push down or lean on your cast. This may cause it to break.
- Do not use sharp objects. Do not use a sharp or pointed object to scratch under your cast. This may cause wounds that can get infected, or you may lose the item inside the cast.
Swelling
Your cast may feel snug, especially the first few days after your injury. Usually this is caused by your body swelling. To help with swelling:
- Prop up the injured part of the body so it is higher than your heart. If the cast is on your leg, lie down and put cushions or pillows underneath. This helps drain blood and fluids away from the injured area.
- Wiggle your fingers or toes on the injured arm or leg, and do it often. This also can prevent stiffness.
- Use a plastic bag of ice, or an ice pack wrapped in a thin towel to chill it from the outside. Keep the ice on the cast at the site of the injury for 15-30 minutes. Repeat every few hours for the first few days. Be sure to keep the cast dry.
- If you feel sore or swollen, ask your doctors if you should take over-the-counter pain meds like acetaminophen or ibuprofen.
Itching
It can be very irritating if you cannot reach a spot you need to scratch. Locate your itch, and tap it on the outside of the cast. You can also try blowing cool air from a hair dryer around the edges of the cast. Do not ever stick a hard object into the cast, such as a pencil, a ruler or any other object, to relieve the itch. That could break your skin. Avoid applying lotions, oils, deodorant, or powder in or around the cast.
Infection
It is normal for your cast to get smelly after you have worn it for a while. But if you notice a foul odor or a discharge coming from the cast, it could mean your skin underneath is infected. Get immediate medical attention.
When to Seek Immediate Care
- Your cast breaks or gets damaged.
- You see drainage, or your cast is stained or smells bad.
- Your skin turns blue or pale.
- Your skin tingles, burns, or is cold or numb.
- You have severe pain that is getting worse and does not go away after you take pain medicine.
- Your limb swells, or your cast looks or feels tighter than it was before.
When to Contact Your Doctor
- Something falls into your cast and gets stuck.
- You have itching, pain, burning, or weakness where you have the cast.
- You have a fever.
- You have sores, blisters, or breaks on the skin around the edges of the cast.
- You have questions or concerns about your condition or care.
Cast Removal
Never remove the cast yourself. You may cut your skin or prevent proper healing of your injury.
Your doctor will use a cast saw to remove your cast. The saw vibrates but does not rotate. If the blade of the saw touches the padding inside the hard shell of the cast, the padding will vibrate with the blade and will protect your skin. Cast saws make noise and may feel hot from friction, but they will not harm you.
If you do feel pain while the cast is being removed, let your doctor or an assistant know, and they will be able to make adjustments.
Rehabilitation
Broken bones take several weeks to several months to heal. Pain usually stops long before the bone is solid enough to handle the stresses of everyday activities. You will need to wear your cast or splint until your bone is fully healed and can support itself.
While you are wearing your cast or splint, you will likely lose muscle strength in the injured area. Exercises during the healing process and after your cast is removed are important. They will help you restore normal muscle strength, joint motion, and flexibility.
Call Ventura Orthopedics Today!
Remember to check in with your body. If you are experiencing pain in your shoulders, neck or back or if you feel numbness or tingling in your hands and arms, it may be time to consult a medical professional.
The experienced and dedicated orthopedic surgeons at Ventura Orthopedics are here for you. If you are concerned about problems that you are experiencing with your shoulders, neck or back, talk to the experts at Ventura Orthopedics today. Call us today at 800-698-1280 to schedule an appointment.
