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Patient education: Cast and splint care (Beyond the Basics)

Author
Paula Schweich, MD
Section Editor
Richard G Bachur, MD
Deputy Editor
James F Wiley, II, MD, MPH
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CAST CARE OVERVIEW

You have been fitted with a cast or splint to protect your bone and reduce pain as you heal. It is important to take care of your cast or splint to minimize the risk of potential complications, such as skin infection. If you have questions or concerns about your cast, contact your healthcare provider.

CAST CARE INSTRUCTIONS

Mild swelling of the injured area is common during the first few days. Swelling may make your cast feel tight initially. To reduce swelling, keep the cast above the level of your heart for 24 to 48 hours. This can be accomplished by resting it on pillows. Also, gently move your fingers or toes (where the cast is located) frequently.

Ice helps keep the swelling down. Apply a bag of ice (or a bag of frozen vegetables) covered with a thin towel to the cast for 20 minutes every two hours while awake. Do not apply ice directly to the skin.

Take your pain medicine if you have pain. After the first few days, you may be able to take a non-prescription pain medication, such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol and others).

To keep your cast dry when you bathe, cover it with two plastic bags, tape each bag (separately) to your skin with duct tape, and hold the cast outside the tub or shower while you wash (picture 1). In young children, you can use two rubber bands, one at the top of each plastic bag, instead of tape. Rubber bands may not be as good at keeping the cast dry, but removing tape from the skin will hurt younger children. Even when covered with plastic, you should not place a cast in water or allow water to run over the area. Waterproof cast covers are available at medical supply stores, but are not completely waterproof.

If the cast becomes wet, you can dry it with a hair dryer on the cool setting. Do not use the warm or hot setting because this can burn the skin. You can also use a vacuum cleaner with a hose attachment to pull air through the cast and speed drying.

Keep the cast clean and avoid getting dirt or sand inside the cast. Do not apply powder or lotion on or near the cast. Cover the cast when eating.

Do not place anything inside the cast, even for itchy areas. Sticking items inside the cast can injure the skin and lead to infection. Using a hair dryer on the cool setting may help soothe itching.

Do not pull the padding out from inside your cast.

WHEN TO SEEK HELP

If there are sore areas or a foul odor from the cast, cracks or breaks in the cast, or the cast feels too tight or too loose.

You develop swelling that causes pain or makes it so you cannot move your fingers or toes.

You develop tingling or numbness in the arm or fingers or toes.

Your fingers or toes are blue or cold.

You develop severe pain in or near the casted arm or leg.

The cast becomes soaking wet and does not dry with a hair dryer or vacuum.

WHERE TO GET MORE INFORMATION

Your healthcare provider is the best source of information for questions and concerns related to your medical problem.

This article will be updated as needed on our web site (www.uptodate.com/patients). Related topics for patients, as well as selected articles written for healthcare professionals, are also available. Some of the most relevant are listed below.

Patient level information — UpToDate offers two types of patient education materials.

The Basics — The Basics patient education pieces answer the four or five key questions a patient might have about a given condition. These articles are best for patients who want a general overview and who prefer short, easy-to-read materials.

Patient education: Cast and splint care (The Basics)
Patient education: Common wrist injuries (The Basics)
Patient education: Elbow fracture in children (The Basics)
Patient education: Finger dislocation (The Basics)
Patient education: Common finger injuries (The Basics)

Beyond the Basics — Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed. These articles are best for patients who want in-depth information and are comfortable with some medical jargon.

This topic currently has no corresponding Beyond the Basics content.

Professional level information — Professional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings. These articles are thorough, long, and complex, and they contain multiple references to the research on which they are based. Professional level articles are best for people who are comfortable with a lot of medical terminology and who want to read the same materials their doctors are reading.

Capitate fractures
Distal radius fractures in adults
Elbow anatomy and radiographic diagnosis of elbow fracture in children
Evaluation and management of supracondylar fractures in children
Fibula fractures
First (thumb) metacarpal fractures
General principles of fracture management: Fracture patterns and description in children
Hamate fractures
Lunate fractures
Metacarpal base fractures
Metacarpal head fractures
Metacarpal neck fractures
Metacarpal shaft fractures
Metatarsal shaft fractures
Midshaft humeral fractures in children
Orthopedic aspects of child abuse
Overview of ankle fractures in adults
Overview of carpal fractures
Overview of metacarpal fractures
Overview of stress fractures
Overview of the causes of limp in children
Overview of tibial fractures in adults
Overview of tibial fractures in children
Patella fractures
Pisiform fractures
Proximal fifth metatarsal fractures
Proximal humeral fractures in children
Proximal tibial fractures in adults
Proximal tibial fractures in children
Scaphoid fractures
Sesamoid fractures of the foot
Splinting of musculoskeletal injuries
Stress fractures of the humeral shaft
Stress fractures of the metatarsal shaft
Stress fractures of the tibia and fibula
Tibial and fibular shaft fractures in children
Tibial shaft fractures in adults
Toe fractures in adults
Trapezium fractures
Trapezoid fractures
Triquetrum fractures

The following organizations also provide reliable health information.

American Academy of Orthopedic Surgeons

     (http://orthoinfo.aaos.org/topic.cfm?topic=a00095)

KidsHealth

     (http://kidshealth.org/parent/firstaid_safe/emergencies/cast_faq.html)

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Literature review current through: Nov 2016. | This topic last updated: Fri Aug 19 00:00:00 GMT+00:00 2016.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2016 UpToDate, Inc.
References
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  1. Cast or splint care at home. Exit Care Patient information. Exit Care LLC. 2008.

All topics are updated as new information becomes available. Our peer review process typically takes one to six weeks depending on the issue.