Patient education: Cast and splint care (Beyond the Basics)

CAST CARE OVERVIEW — You have been fitted with a cast or splint to protect your bone and reduce pain as you heal. It is important to take care of your cast or splint to minimize the risk of potential complications, such as skin infection. If you have questions or concerns about your cast, contact your health care provider.

CAST CARE INSTRUCTIONS

●Mild swelling of the injured area is common during the first few days. Swelling may make your cast feel tight initially. To reduce swelling, keep the cast above the level of your heart for 24 to 48 hours. This can be accomplished by resting it on pillows. Also, gently move your fingers or toes (where the cast is located) frequently.

●Ice helps keep the swelling down. Apply a bag of ice (or a bag of frozen vegetables) covered with a thin towel to the cast for 20 minutes every two hours while awake. Do not apply ice directly to the skin.

●Take your pain medicine for at least 48 hours. Acetaminophen (sample brand name: Tylenol) or ibuprofen (sample brand names: Advil, Motrin) usually provide adequate pain relief.

●To keep your cast dry when you bathe, cover it with two plastic bags, tape each bag (separately) to your skin with duct tape, and hold the cast outside the tub while you wash (figure 1). In young children, you can use two rubber bands, one at the top of each plastic bag, instead of tape. Rubber bands may not be as good at keeping the cast dry, but removing tape from the skin will hurt younger children. Even when covered with plastic, you should not place a cast in water or allow water to run over the area. Waterproof cast covers are available at medical supply stores, but are not completely waterproof.

●If the cast becomes wet, you can dry it with a hair dryer on the cool setting. Do not use the warm or hot setting because this can burn the skin. You can also use a vacuum cleaner with a hose attachment to pull air through the cast and speed drying. If the cast remains wet, please have it checked by your provider, because a wet cast can cause skin breakdown.

●Keep the cast clean and avoid getting dirt or sand inside the cast. Do not apply powder or lotion on or near the cast. Cover the cast when eating.

●Do not place anything inside the cast, even for itchy areas. Sticking items inside the cast can injure the skin and lead to infection. Using a hair dryer on the cool setting may help soothe itching.

●Do not pull the padding out from inside your cast.

●Children with casts can go to school and play appropriately.

WHEN TO SEEK HELP

●If there are sore areas or a foul odor from the cast, cracks or breaks in the cast, or the cast feels too tight or too loose.

●You develop swelling that causes pain or makes it so you cannot move your fingers or toes.

●You develop tingling or numbness in the arm or fingers or toes.

●Your fingers or toes are blue or cold.

●You develop severe pain in or near the casted arm or leg.

●The cast becomes soaking wet and does not dry with a hair dryer or vacuum.

WHERE TO GET MORE INFORMATION — Your health care provider is the best source of information for questions and concerns related to your medical problem.

This article will be updated as needed on our website (www.uptodate.com/patients). Related topics for patients, as well as selected articles written for health care professionals, are also available. Some of the most relevant are listed below.

Patient level information — UpToDate offers two types of patient education materials.

The Basics — The Basics patient education pieces answer the four or five key questions a patient might have about a given condition. These articles are best for patients who want a general overview and who prefer short, easy-to-read materials.

Patient education: How to care for your cast (The Basics)
Patient education: How to care for your child's cast (The Basics)
Patient education: Common wrist injuries (The Basics)
Patient education: Elbow fracture (The Basics)
Patient education: Finger dislocation (The Basics)
Patient education: Common finger injuries (The Basics)

Beyond the Basics — Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed. These articles are best for patients who want in-depth information and are comfortable with some medical jargon.

This topic currently has no corresponding Beyond the Basics content.

Professional level information — Professional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings. These articles are thorough, long, and complex, and they contain multiple references to the research on which they are based. Professional level articles are best for people who are comfortable with a lot of medical terminology and who want to read the same materials their doctors are reading.

Capitate fractures
Distal radius fractures in adults
Elbow anatomy and radiographic diagnosis of elbow fracture in children
Supracondylar humeral fractures in children
Fibula fractures
First (thumb) metacarpal fractures
General principles of fracture management: Fracture patterns and description in children
Hamate fractures
Lunate fractures and perilunate injuries
Metacarpal base fractures
Metacarpal head fractures
Metacarpal neck fractures
Metacarpal shaft fractures
Metatarsal shaft fractures
Midshaft humeral fractures in children
Ankle fractures in adults
Overview of carpal fractures
Overview of metacarpal fractures
Overview of stress fractures
Overview of the causes of limp in children
Overview of tibial fractures in adults
Overview of tibial fractures in children
Patella fractures
Pisiform fractures
Proximal fifth metatarsal fractures
Proximal humeral fractures in children
Proximal tibial fractures in adults
Proximal tibial fractures in children
Scaphoid fractures
Sesamoid fractures of the foot
Basic techniques for splinting of musculoskeletal injuries
Stress fractures of the humeral shaft
Stress fractures of the metatarsal shaft
Stress fractures of the tibia and fibula
Tibial and fibular shaft fractures in children
Tibial shaft fractures in adults
Toe fractures in adults
Trapezium and trapezoid fractures
Triquetrum fractures

The following organizations also provide reliable health information:

●American Academy of Orthopedic Surgeons

●KidsHealth