Cast Care

If your child has just had a cast applied, the information below will explain how to care for the cast. If the cast makes your child uncomfortable or if she has trouble getting used to it, call your child’s doctor for advice and suggestions.

Caring for a cast

As long as your child has a cast, follow these instructions.

• Keep the cast elevated for the first 48 hours (2 days). Whenever your child is resting (either sitting or lying down) keep the arm or leg that is in the cast elevated above the level of the heart. For leg casts, provide support for the leg under the calf and not just at the heel. This helps prevent pressure sores on the heel.
• Be sure that the top end of the cast does not indent the skin and muscle when sitting with the cast resting with the cast supported. This may cause discoloration and swelling of the fingers or toes.
• Change the position of the arm or leg about every 2 hours. This keeps the cast from putting too much pressure on the skin in any area. Observe the skin under the top edge of the cast. An early sign of too much pressure is indented skin. A later sign is swollen or discolored fingers or toes.
• Check the skin around and under the cast every day for sores or red areas. Press the skin down all around the cast so you can look under the cast.
• Help your child exercise the fingers or toes of the arm or leg that is in a cast.
• Tap on the cast with a hard object, such as a metal spoon, to relieve itching.
• Use a hair dryer or fan to blow cool air under the cast. This may help if your child’s skin is itchy. It also helps the cast to dry, if it becomes sweaty.
• If the itching is very bad, take over-the-counter Benadryl® as a last resort.
• Your child can only have sponge baths while wearing the cast. Cover the cast with a plastic bag to protect the cast during the sponge bath. Talk with your child’s provider for ideas if bathing is a problem.
• If your child has a fracture with pins outside the skin, it is especially important not to have water get inside the cast..

DO NOT

• Do not get the cast wet. A plaster cast will crack and crumble.
• Do not let the cast dip into bathwater, even while in a plastic bag.
• Do not let your child put any objects inside the cast for any reason. This can cause serious injury to the skin.

When to Call Your Provider

Call your child’s provider immediately if:

• There is any swelling above or below the cast.
• Your child has a fever, and there is a surgical incision or pins under the cast.
• Your child says the cast feels too tight.
• There is a bad smell coming from inside the cast.
• Your child complains of pain that does not go away.
• Your child’s skin becomes red or sores develop around the edges.
• Your child’s cast gets wet. A wet cast can usually be changed in the office the next day.

Solving Problems at Home

You may be able to solve some problems on your own. If the steps described here do not help, you will need to call the office.

• The fingers or toes may change color. If they become bluish or gray, reposition or elevate the cast. If there is no improvement within a few minutes, call the clinic.
• If your child’s fingers or toes feel cold, reposition the cast and cover the fingers or toes. Check your child’s circulation in the arm or leg that is in the cast. To check the circulation, press on a toenail or fingernail. The nail should turn white. When you let go, the nail should turn pink again right away. If the nail does not turn pink, call the office. If the nail does turn pink, keep the fingers or toes covered for 5 to 10 more minutes. If they still feel colder than the other hand or foot, call the office.
• Your child may notice a numb or tingling feeling. If this happens, elevate the cast. If the numbness or tingling is still there 10 to 25 minutes later, call the clinic.
• If your child’s cast gets damaged or broken, call the office. You will need to make an appointment to have it fixed or to have a new cast put on.