Cast and Splint Care Tips

Topic Overview

When you first get your cast or splint

Your doctor has applied a cast or splint to protect a broken bone or injury. If you have a removable splint, follow your doctor's instructions and only remove the splint if he or she says you can. If you have a cast, follow your doctor's instructions for when you can first put pressure on the cast. Fiberglass casts dry quickly, but plaster casts may take several days before they are hard enough to use. Once your cast is hard enough, don't put excessive weight on it for long periods of time without rest.

Never cut or modify your cast or splint or use powder on the skin under the cast. Keep dirt and sand from getting into the cast.

Swelling

You will probably have swelling for a few days after your surgery or injury that can make your cast or splint feel tight. Reduce the swelling by raising the injured arm or leg above your heart as often as possible during the first 72 hours after you get your cast or splint. You may need to lie down, and it helps to use a pillow to prop up the arm or leg and to cushion it from hard surfaces.

Put ice in a plastic bag, wrap it in a towel, and place it over the injured area. If you have a plaster cast, do not allow the cast to get wet or damp. Ice the area several times a day for about 15 minutes at a time.

Taking nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation. Wiggle your uninjured fingers or toes as much as possible. Be sure to follow the medicine precautions on the bottle or box.

Call your doctor immediately if:

• You can't move your fingers or toes.
• You have severe pain or increased pain that you think is from swelling, and your cast or splint feels too tight.
• Your hand or foot feels numb or tingles.
• You have a lot of swelling below your cast or splint.
• The skin under your cast or splint is burning or stinging.

It's also important to keep up your muscle strength and tone as much as possible while protecting your injured limb or joint. Your doctor may want you to tense and relax the muscles protected by the cast or splint. Check with your doctor or physical therapist for instructions.

Keeping a cast or splint dry

• Unless you have a fiberglass cast with a quick-drying lining, do not get your cast wet. If you have a removable splint, ask your doctor whether it's okay to remove it to bathe. Even though the splint is removable, your doctor may want you to keep it on as much as possible.
• Keep your cast or splint covered with at least two layers of plastic when showering or taking a bath or when you have any other contact with water. Moisture can collect under the cast or splint and cause skin irritation and itching.
• If you have a wound or have had surgery, moisture can increase the risk of infection.
• If you have a fiberglass cast with a fast-drying lining, make sure to rinse it with fresh water after swimming. It will take about an hour for the lining to dry.

Itchy skin

Itchy skin is common under a cast. Blowing cool air from a hair dryer or fan into the cast may help. Never stick anything inside your cast to scratch the skin.

Don't use oils or lotions near your cast. If the skin becomes red or irritated around the edge of the cast, you may pad the edges with a soft material or use tape to cover it. Call your doctor if you think you have a skin infection.

Complications of wearing a cast

Severe or increasing pain may be a symptom of a serious problem. Compartment syndrome is caused by swelling within the space or "compartment" that contains muscles, nerves, blood vessels, and bones. Pressure on arteries, veins, and nerves causes severe pain, slows circulation to the muscles and nerves, and may cause permanent damage to these tissues. Compartment syndrome is a medical emergency that requires prompt treatment.

Pressure sores are another problem that may develop over a bony area under the cast or splint, such as an elbow or ankle. You may get a pressure sore if your cast or splint is too tight. A warm spot on the cast or splint, pain, drainage, and an odor are symptoms that a pressure sore or skin infection may be present. Call your doctor if you think you have a pressure sore or skin infection under your cast or splint.

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Author:	Sydney Youngerman-Cole, RN, BSN, RNC	Last Updated August 31, 2006
Medical Review:	William M. Green, MD - Emergency Medicine H. Michael O'Connor, MD - Emergency Medicine
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