Please read the information below for directions about caring for your cast.
Why do I need a cast?
You have been given a cast to help your broken bone or torn ligaments heal. A cast can help keep the injured area from moving so you can heal faster without risk of repeated injury. How long you'll need to wear your cast depends on the type of injury you have and how serious it is. Normally casts are worn between 4 and 6 weeks.
Will the broken bone hurt?
Almost all broken bones cause pain. The cast should relieve some pain by limiting the movement of the broken bones or damaged soft tissue. Your pain should become less severe each day. Most of the pain associated with a fracture is due to swelling after the cast is applied, thus, reducing the swelling is key in keeping your pain to a minimum. Below are a few tips to keep you or your loved one comfortable:
Elevate your extremity
Elevate your extremity above your heart as much as possible. The first 48 hrs after your fracture is critical in reducing the swelling. To elevate your extremity properly follow these simple instructions:
- If it is your Leg, take some large pillows such as your large couch or chair cushion and place it on your bed. Lie flat on your back and have the leg propped up on the pillow. Keep adding the pillows until your leg is at least 10cm (over 1.25 inches) above your heart level. Remember, that lying in a Lazyboy Chair is NOT elevating your leg above your heart.
- If it is your Arm, take the pillow from your bed and place it across your chest. Place the cast on the pillow to ensure that it is above your heart. A second option is to place pillows on either side of your elbow and point your fingers to the ceiling. When you are walking, remember to keep your arm elevated as though you are waving "Hi" to everyone.
Ice your cast for the first 48 hours
Yes, the ice will penetrate through your cast if you leave it on long enough. This will help reduce any swelling and pain. One of the best methods to ice down your cast is to use bags of frozen vegetables. We have found the use of frozen peas or corn seem to work the best. It is also useful to have at least two (2) bags available to provide continual therapy to your cast. Keep one or two bags (one bag for the arm and two for the leg) on the cast and switch these approximately every 90 minutes. Maintain the other bag in the freezer so it can be reused immediately. When it is time for bed, a good idea is to keep all of the cold bags in a cooler next to your bed. When each pack becomes warm, just reach over and pull out the fresh bag from the cooler and place the used one back in. This prevents those painful trips to the freezer in the middle of the night. If you do not have any frozen vegetables, you may use ice placed into two zip-lock or plastic bags wrapped with a towel to prevent leakage.
Take your medication
Take your medication regularly for at least the first 48 hours. When you return from the hospital or clinic, take some pain medication as directed. You may not be in any discomfort at that time, however, your doctor may have given you a local anesthetic that numbs your fracture for a short while. This may wear off soon and you will want the pain medication circulating in your body to ease this transition. Only take what the amounts and dosages given by your doctor. Do not exceed the dosages without discussing this first with your doctor.
Call your doctor immediately if the pain in the casted area gets worse after the cast has been applied. You should also call your doctor right away if you have new pain that develops in another area (for example, pain in your fingers or forearm if you have a wrist or thumb injury, or pain in your toes or calf if you have an ankle or foot injury).New pain that you didn't have before the injury may mean that the cast is too tight. If you have this symptom, raise your cast. This may reduce pain and swelling.
Is it okay to get the cast wet?
The answer is NO! If you get one of these casts wet, irritation and infection of the skin could develop. To avoid getting the cast wet
- Never submerse the cast in water. Nothing is waterproof.
- Wrap a dry absorbent Terry Cloth towel around the cast first and tuck it into the edges to absorb any dampness which may soak through.
- Take a plastic bag (a bread bag works for small casts and a trash bag for larger casts) and wrap it around the cast.
- Use a rubber band or water proof tape to wrap the top of the cast.
- You can take a bath if the cast hangs out of the tub safely. Do not submerge the cast. If you take a shower, point the spray away from the cast.
- When you are done with your bathing, dry everything off first including your hair and than take the plastic covering off the cast. This is to avoid the wetness from rolling down into your cast.
If the cast does get wet, you may be able to dry out the inside padding with a blow dryer. (Use a low setting and blow the air through the outside of the cast.) If the cast gets completely soaked, you must contact us to avoid damage to your skin.
It may come as a surprise to most people, but much of innovation in the field of orthopedic surgery happens in private practices such as ours, not in universities. Our surgeons utilize the most advanced technologies in treating your problem. They are experts in the field of joint replacement, arthroscopy, foot and ankle surgery, and sports medicine.
What can I do about itching?
If your skin itches underneath the cast, don't slip anything inside the cast, since it may damage your skin and you could get an infection. Instead, try tapping the cast or blowing air from a blow dryer down into the cast. You may also find that benedryl (purchased over the counter) is helpful.
- You can purchase a cast bag from a local pharmacy or from our office. These are durable, reusable bags that are designed to help keep your cast dry and clean. They are NOT waterproof and you still need to avoid submersing your cast.
- You may want to gather together some older clothes and split the seems to allow easier dressing, or you can use some loose fitting sweats or scrubs.
- Move your fingers and toes frequently in a "pumping" motion to help reduce swelling. The first few motions may produce some soreness but this is fine, this soreness should reduce with further movement. You can perform these "pumps" 10 times every hour.
- Gait Training is available if you have trouble walking or you feel unstable using your crutches. Please contact us if you would like to make arrangements for this service.
- To reduce your risk of blood clots and promote the healing of your bone, don't even think about smoking. Smoking will significantly decrease your chance for a speedy recovery.
- Take one aspirin per day if you are over the age of 16 to decrease your chance of a blood clot from forming.
Danger Signs, When to Call
Report any of these symptoms immediately:
- Increased swelling at either end of your cast that will not decrease with elevation, ice and taking the medication.
- Coldness of the skin at either end of the cast that is not related to the use of the ice.
- Tingling or numbness that is progressive and not relieved with elevation.
- Extreme pain not relieved with the elevation, ice and the medication.
- Change in the color of your skin to a deep blue or very pale color that is again not relieved with elevation.
- An area of the cast that becomes progressively painful sometimes referred to as a "hot spot."
- A foul odor from your cast that is not normal.
- If anything is caught under the cast since this can cause the skin to breakdown.
We know that having a break and a cast is a bummer, but following these directions and working as a team together will make the experience more tolerable.
For your convenience, you can download a PDF version of this information to keep on your computer or to print out for easier reference.