Plaster and Fiberglass casts are the most frequent treatment for fracture care. They are carefully applied to protect as well as maintain the broken fragments in position until the fracture heals. To do so, the cast has to fit well to the surface of the broken part. It also has to be well padded to prevent excessive irritation. A full cast covers all around the broken bone and thus has limited room for swelling. Excessive swelling beyond the capacity for the cast will increase the pressure inside and ‘cut of the circulation’. This is a serious problem and needs to be prevented among other things. When I apply a cast, I will remind you of the following:
- DO NOT Get your cast wet. Cover it with a plastic bag, clear cling wrap, or designated cast covers when you get near water. Sponge bathing with your broken extremity hanging outside of the tub is safer than taking a shower. If the wetness reaches deep, call my office or make arrangements to have it replaced soon.
- DO NOT remove your cast. You may cut yourself or disturb the fracture before it has healed. Cast removal requires a special oscillating cast vibrates, rather than rotate and does not cut through skin.
- DO NOT stick anything down the cast. You may cut or stab yourself and you may break the tip and lose it inside.
- DO NOT put powders or lotion inside the cast.
- KEEP your extremity elevated. the wrist goes above the elbow and the elbow goes above the heart.
- APPLY cold packs (frozen vegetable bags will do) intermittently around the cast.
- MOVE your fingers frequently to help pump any swelling back to your body.
Serious Signs to Watch For
- Increasing pain, numbness, swelling,
- bluish discoloration of the finger tips, or loss of active movement of your fingers
- the feeling that the cast is too tight.
The above are serious signs and require immediate attention. Please report immediately or visit the nearest emergency department.The most critical period of time is the first two days after the application of the cast.
- Intolerable itching, burning, pain. Please report immediately.
- Cracks or breaks in the cast. Please report immediately.
- Loose cast. With time, as swelling goes down, the cast may become loose. A loose cast is less effective than a fit cast. Please report immediately.
- If itching occurs, try a hair drier to blow cool room temperature air into the cast. NEVER blow warm or hot air into the cast.
- Feel free to pad any rough edges to protect your skin from scratches. Cloth tape usually does a good job.
- Do not miss your appointments. They are scheduled to watch for fracture healing, make sure the alignment has not been disturbed, and that your cast is fit and appropriate. Missing an appointment may mean missing an opportunity to address a problem in a timely manner.