Cast and Splint Care

 
Casts and splints support and protect injured bones and soft tissue. They can be used to keep bones aligned, protect them from further injury, reduce pain, swelling, and muscle spasm.

Splints or "half casts" are often used when swelling is expected to increase. Sometimes a splint is better suited than a cast to a particular area of the body.

Splints may be "off-the shelf" types that fasten with Velcro, or custom made from fiberglass or plaster. Your splint may be removable, but you should follow your doctor's advice about whether to remove it or not, depending on your particular condition.

Casts are usually made of a fiberglass material, which is lighter and stronger than the older plaster cast material, and more transparent to X-rays that may be needed during the healing process.

SWELLING

Swelling due to your injury may cause pressure in your splint or cast, especially during the first 72 hours. This may cause your injured arm or leg to feel snug or tight in the splint or cast.

To reduce swelling:
• Elevate your injured arm or leg just aboveheart level by propping it up on pillows or other support. Lying down will help you to elevate the part effectively. Having your arm in a sling is not enough. Elevation allows fluid and blood to drain "downhill" to your heart.
• Wiggle your uninjured fingers or toes often.
• Ice can be helpful to reduce swelling, but is difficult to apply effectively when a cast or splint is in place. It can be of some benefit if placed in a dry plastic bag and wrapped loosely around the cast or splint at the level of the injury.

Sometimes it may be necessary to replace a cast as swelling subsides, and the cast "gets too big." (Actually, the cast does not change size, but the body part tends to shrink.) Some "loosening" of the cast is acceptable, but if it becomes uncomfortably loose and begins to rub sore places inside the cast, you should contact us.

Excessive swelling can produce increased pain, slower healing, and in more severe cases can be dangerous to the circulation of the arm or leg. You should contact us immediately (910 772-9930) if any of these warning signs occur:
• Severe pain, with a feeling that the cast or splint has become too tight
• Numbness and tingling which does not go away promptly as you change position
• Persistent burning and stinging pain under the cast
• Severe swelling below the cast
• Loss of ability to move toes or fingers below the cast

BATHING

You should keep your cast dry. Even though the fiberglass material is not harmed by moisture, the padding will become wet, and can be extremely irritating to the skin. Bathing can be accomplished by covering the cast with two layers of plastic bag, carefully taping the plastic at the top, or by use of commercial waterproof cast shields (Drycast®, Xerosox®) available from home health supply stores, brace shops, and most pharmacies. With some longer casts, it may be necessary to "sponge bathe" rather than try to shower and risk wetting the cast.

If the cast accidentally becomes wet, it may be possible to dry the cast with towels followed by use of a blow dryer, but this can take several hours. If you do not feel that the cast padding is dry, you will need to contact us so that the cast can be replaced.

ITCHING

Do not stick objects such as sticks or coat hangers inside the splint or cast to scratch itching skin. Damage to the skin can be produced with these objects. Most itching can be relieved by aiming a blow dryer ON A COOL SETTING to blow cool air inside the cast, from the top or bottom edge of the cast. If itching is severe and persistent, a skin allergy could be present, and you should contact us.

WALKING

If you have a "walking cast," you will be permitted to put some or all of your body weight on the cast when you walk or stand. You will be provided with a "cast boot," which should be placed over the foot portion of the cast whenever you walk. This protects the cast and provides traction. The cast boot can be removed if you are sitting or lying down. If it is painful to put full weight on the injured limb, you should use crutches or a walker to reduce pressure on the cast until this has improved. Of course, you should not bear any weight on the cast unless your doctor has told you that you may.

CAST REMOVAL

Cast removal is done with a specialized saw. The saw blade vibrates, but does not spin. This allows the blade to cut the hard cast material without cutting the cast padding or skin underneath, which can vibrate with the blade. A cast saw is quite noisy, and you may feel some heat from the blade, but cast removal should not be painful.