Cast Care

Splints and Casts protect and support ligaments, bones and soft tissue especially when a serious injury occurs. Sometimes a Splint or Cast is applied after undergoing surgery. A splint or cast helps to reduce swelling, pain, and even muscle spasm.

Splints sometimes referred to as "half casts" provide less support than casts. But, splints can be adjusted to fit each individual, so the injured area can better adapt to the swelling that sometimes occurs after an injury. If the injured area is swollen, it is easier to apply a splint than an enclosed cast. The doctors will determine whether a splint or cast will be applied, based on each patient’s injury. Each splint or cast is custom-made, and will be applied by the attending doctor.

Types of splints and casts

The materials from which most casts are made are plaster or fiberglass . If an exact fit is necessary, custom-made casts are made to fit the patient. If an exact fit is not necessary, a ready-made splint will be used. Ready-made-splints are easier and much faster to use. They come in many varieties, shapes and sizes. Velcro straps make a splint easy to adjust. They can readily be put on and taken off for the convenience of the patient. The attending doctor will explain and show you how to use and adjust your splint in order to accommodate swelling that may occur, after the splint is applied to the injured area.

When you have a broken bone, plaster splints are commonly placed onto the injured area. To protect the skin, several layers of cotton are wrapped around the injured area, before both plaster and fiberglass casts are applied. Therefore, the cotton must be kept clean and dry to insure comfort to the injured site. Because plaster becomes pliable and heavy when wet, it must always be kept dry. Water distorts the shape of the plaster and can cause problems with the fitting of the cast. When this occurs, it eventually delays the healing process.

Ace bandages, along with bulky cotton, are used to pad the splint, so that the patient’s injured area is made comfortable. When the injured area is too swollen, the site may need to be iced and elevated, before and after the splint is applied. Swelling sometimes impairs circulation to the extremities (fingers and toes) and can cause problems. This is why a plaster splint is commonly used instead of a plaster cast; the splint allows room for swelling. After the plaster splint is applied, each patient should observe the injured area, especially for redness or swelling. If the area swells or turns red, call the doctor immediately. The splint may have to be removed or adjusted.

When the swelling goes down, the plaster splint may become too loose and may have to be removed. At this time, the doctor will determine whether a fiberglass cast will be applied to the injured area, instead of the plaster splint. Initially, plaster is used because it can be molded to insure a proper fit, keeping the injured area protected until it is healed. But because of the weight of plaster, fiberglass is a good alternative. It’s a lighter weight, has breatheability and durability. Fiberglass casts also require less maintenance than plaster casts.

Usually, for the first week after breaking a bone, a plaster cast is applied to the injured area. After one week, or at the next doctor visit, a fiberglass cast may then be applied and changed every three to six weeks, as needed, until the bone is healed and the cast is ready to be removed.

Taking Care of Your Cast

Elevating the cast

To prevent swelling, the injured area should be elevated. Especially, within the first 48 hours, after the injury occurred.

Exercise the fingers and toes that are exposed

Even if your leg or arm is in a cast; exercise the extremities (fingers and toes). But if exercise causes pain, call doctor immediately.

Applying an ice to the cast.

The injured area needs to be reduced from swelling. Applying ice, contained in an ice bag or a plastic bag wrapped in a towel, is very important. When icing the broken bone, do not place ice directly on skin or on the cast material. This can cause damage to both your skin and the cast. Make sure you keep both areas clean and dry.

The cast must be kept dry:

The cotton wrapped around the injured site must always be kept dry. When washing,, wrap the cast carefully in a plastic bag to insure that water will not penetrate the bag and run onto or into the cast

Don't put anything inside or under the cast.

The injured site may get very itchy. And you may find it tempting to stick objects under the cast to scratch the inside, but refrain from doing so. If you stick objects under the cast you may injure your skin or damage the cast as well.

How to relieve itching under the cast

Benadryl can be helpful. You may purchase this, over-the-counter, at your local pharmacy. Using a hair dryer, on a cool setting, is also helpful. Point the hairdryer downward to get air under the cast, until the itching subsides.

Trimming rough edges around the cast

Use an emery board to file away rough edges of the cast. Using scissors can be dangerous. Do not attempt to break away rough edges of the cast, by doing so, you may damage it.

Check the cast carefully.

Do regular inspections of your cast. If your cast cracks, breaks or starts to become too loose, call your doctor immediately. Also check the areas of skin around the cast. If the skin becomes red or irritated, padding can be added to these irritated areas to prevent any further problems.