What is a cast?
Casts are most often used to help mend broken bones by immobilizing the injury, protecting the area recovering from a fracture or surgery, and reducing pain caused by motion.
A cast is a stiff, solid dressing that supports a body part while a bone is healing after an injury. Some casts are made of plaster and some of fiberglass. At first the cast will be heavy, damp and warm as it is being applied.
How do I care for my child’s cast?
- After application let the cast dry completely. If your child has a fiberglass cast is usually takes 30 to 45 minutes to dry. If your child has a plaster cast, it usually takes one to three days to dry.
- Keep the arm or leg with the cast raised above the level of the child’s heart to prevent swelling.
- Examine the cast daily for cracks or soft spots. Check the skin for redness, blisters or sores along the cast edges and be alert to any bad odor from the cast.
- Once the cast is dry, you can tape over the rough edges if it is causing the child irritation.
- To prevent swelling and alleviate pain an anti-inflammatory, such as Advil, should be taken for three to five days following the injury.
- Do not use lotions, oils or powder around the edges or under the cast.
- If a plaster cast becomes dirty you can clean it with a damp cloth; however, do not use soap or get the cast wet.
- If a fiberglass cast gets dirty, clean it with a damp cloth and soap. Baby wipes can also be used. Be sure to wipe off any remaining moisture.
How do I care for my child?
- Give your child a sponge bath. Cover the cast with a plastic bag during the sponge bath. Use a damp cloth and mild soap to clean his or her skin. Dry him or her completely with a towel.
- You may bathe your child in a bathtub if you use a cast protector.
- While your child is awake, change the position of the limb with the cast about every two hours. This helps to keep the pressure of the cast off the skin.
- Be sure the top end of the cast does not indent the skin when sitting or resting. This can cause skin damage and swelling of the limb.
- Remind your child not to scratch or put anything inside the cast. Keep small objects that could easily slip into the cast away from the child.
- Gently pat the cast above the area that itches.
- Keep your child as cool as possible.
- Put a well-sealed ice bag on the cast over the area that itches.
- Change your child’s position to shift the weight of the cast.
- Use a hairdryer to blow cool air under the cast.
- If itching is a problem, you may use a non-prescription medication such as Benadryl.
Check for sensation and circulation
- Every eight hours be sure to check that your child’s cast is not too tight and that blood can flow well around the cast.
- Movement of toes and fingers: Have your child move or wiggle fingers or toes.
- Sensation: Touch the area above and below the cast several times a day. Call your child’s physician if your child complains of numbness, tingling or pain.
- Blood flow: Press briefly on your child’s middle fingernail or large toenail several times a day. When it turns white, let go. If pink color does not return in three seconds, call your child’s physician.
- Temperature: If your child’s hand or foot with the cast is cold, cover it with a blanket or sock and raise it above the level of the heart. Check again in 20 minutes. If it is still cold, check feeling and blood flow. If you think there may be a problem, call your child’s physician.
- Severe swelling: Look for swelling above and below the cast. A little swelling is normal. Compare the limb with the cast to the other one. If there is swelling raise it higher than the level of the heart for one hour. Call your child’s physician if the swelling does not go down.
When a cast covers a wound there will be some red or reddish-brown drainage for the first two days. After two days, drainage may be a sign of a problem. Keep track of the area of the drainage and write down the date and time it happened. Call your child’s physician if drainage does not decrease or if drainage is bright red.
Have your child rest the first few days. Do not let him or her do anything too tiring or active such as running, jumping or climbing. The child’s physician will determine when the child can become more active.
Signing the cast
Friends and family may want to sign your child’s cast. That is ok. Be sure to use a felt-tip marker and do not let them paint over large areas. This could seal the cast so air cannot get in, which can hurt the skin under the cast.
How is the cast removed?
Sometimes a cast will need to be removed for a short time to check the part of the body it covers. When the bone has healed completely the cast will be removed permanently.
- A cast tech will use a vibrating cast cutter to open both sides of the cast from one end to the other. The cutter will make a loud buzzing noise, similar to a vacuum. Your child may feel pressure or tingling but it will not hurt.
- The cast tech will then spread the two halves of the cast with a metal tool.
- Finally the cast tech will use special scissors to cut the cotton lining.
- The limb may look and feel a little different for a while. The skin might look dry and pale; use moisturizing lotion to soothe the dry skin.
- Your child’s physician will check your child’s limb to see how it has healed. Sometimes, X-rays are taken. Your child’s physician will let you know if any other treatment is needed.
Learn more about pediatric orthopedic care at OrthoIndy.