CAST CARE Helping Broken Bones Heal
When You Need a Cast Are you injured and in need of a cast? Don t worry, you ll get through it. Wearing a cast will help your injured body part heal. Healing takes time, but you can help yourself by taking good care of your cast and your injury. Read on to learn more. Answering Your Questions You re likely wondering about your cast and how to care for it. This booklet can answer many of your questions, such as: Why do I need a cast? Most likely, you need a cast because you have a broken bone (fracture). To heal correctly, the injured bone or bones must be kept from moving. A cast holds the injury in place. (Casts may also be used for sprains or after planned surgeries.) How long will I wear a cast? This depends on your injury. In most cases, a cast is worn for 4 to 12 weeks. You may need more than one cast before your injury is fully healed. For details about how long you will need a cast, talk to your healthcare provider. 2 Cast Care
Your Healthcare Provider s Role Your healthcare provider will examine your injury and explain treatment. To help you heal, your healthcare provider will: Evaluate your injury. This includes taking x-rays (pictures of your bones). Pieces of broken bone may need to be lined up so they heal straight. In some cases, surgery is needed to do this. Apply the cast. As you heal, your first cast may be replaced with a new one. Prescribe medication, if needed. This can help manage any pain you may have from your injury. Follow up to see how well you re healing. Remove your cast when your injury is healed. Your Role Don t let wearing a cast stop you from doing most of the things you enjoy. Just remember: Take care of your cast. This helps keep your injury from moving while it heals. Take care of your injury to reduce pain and improve your chances of healing well. Take pain medications as directed. Follow up with your healthcare provider as scheduled. Follow any special instructions you are given. When You Need a Cast 3
When Bones Break Sites of fractures that may need a cast Casts are often used for fractures in the hands, arms, legs, or feet. There are many types of fractures. But all fractures heal the same way: New bone grows to connect the broken pieces. A cast holds broken bones in place while they heal. How Bones Break Depending on the injury, bones can break in different ways. These are the most common types of fractures. (You may have a fracture that s not shown here.) Nondisplaced Fracture Bone fragments (pieces) are lined up. Comminuted Fracture The bone is broken into three or more pieces. Displaced Fracture Bone fragments are not lined up. Open Fracture The bone breaks through the skin. Greenstick Fracture The bone bends, but may not break all the way. This is a common fracture in children, whose bones are softer and still growing. 4 Cast Care
How Bones Heal Bone is living tissue made up of cells. When a bone breaks, cells in the blood rush to the fractured area. These cells grow into new bone. Bones heal through a gradual process called remodeling. The length of this process depends on the type of fracture and how well the injury is cared for. Blood clot Tissues bleed around the fracture. This forms a blood clot in the space between the bone fragments. Notes for Kids (and Parents) Fibers Cells form a network of fibers inside the blood clot. These fibers help hold bone fragments together. Since a child s bones are still growing, there are a few special concerns with healing: Growth plates are fragile groups of cells at the ends of a child s long bones, such as in the arms and legs. Growth plates ensure the bones keep growing until they reach full length. Fractures of growth plates may require more follow-up to make sure the bones are growing properly. Remodeling happens more quickly in children than in adults. This means a child s broken bone may not need to be lined up perfectly. As it heals, the bone straightens through remodeling. Fracture callus The fibers are replaced by new bone. At first, the new bone is weak and spongy (fracture callus). Growth plate The new bones grow stronger. The fracture callus shrinks as the bone is used. Growth plate fracture If a fracture goes through the growth plate, the bone may not grow correctly. When Bones Break 5
Getting to Know Your Cast Like it or not, you ll have your cast for a while. Your healthcare provider will decide what type of cast will work best for your injury. Certain aids may also be prescribed to make living with your cast a little easier. Synthetic Casts A synthetic cast is made from fiberglass or plastic strips. These are wrapped around the injury over cotton padding. Synthetic casts can be different colors. A synthetic cast is lighter than plaster. It dries in about 10 minutes but may take an hour to harden fully. Plaster Casts A plaster cast is made from gauze and plaster strips soaked in water. These are wrapped around the injured body part over cotton padding. As they dry, the strips harden. The cast takes 24 to 48 hours to harden fully. Cast Braces A cast brace is made of hard plastic. Soft pads inside the brace compress (push against) the injury. The brace is held in place with Velcro strips. It should not be removed without the healthcare provider s approval. A cast brace may be used right after the injury occurs. Or, it may be used toward the end of healing, after another cast has been removed. Splints A splint (also called a half cast) is made from fiberglass or plaster materials to hold the injury still. A bandage is wrapped around the injury to hold the splint in place. Splints are often used in the emergency room. The splint may then be replaced with another type of cast. 6 Cast Care
Aids to Help You Heal Casts can be heavy and awkward. Walking can be tough if you have a cast on your leg or foot. Your healthcare provider may even tell you to keep weight off your injured leg or foot. Cast aids help you get around safely and comfortably. If you need any of these aids, your healthcare provider will teach you how to use them. A cane helps you balance and put less weight on an injured leg. A walker helps you balance and keep weight off an injured leg. Some walkers have wheels and can be pushed as you walk. Others are lifted and placed down as you step. A sling keeps your injured arm still and helps carry your cast. A walking cast is a cast you can walk on. You may wear a cast shoe over your cast to keep it clean and protected. Crutches help you balance and keep weight off an injured leg. When using crutches, support yourself with your hands and upper arms. Don t rest crutches in your armpits. Getting to Know Your Cast 7
Caring for Your Cast A damaged cast can prevent your injury from healing well. If your cast becomes damaged, it may need to be replaced. This may make healing take longer. Take good care of your cast to help it last. Keeping Your Cast Dry If a plaster cast gets wet, it can soften and fall apart. And if the padding of a synthetic cast gets wet, it can irritate and damage your skin. So plaster and synthetic casts must stay dry. Avoid activities that can get your cast wet. These include swimming, fishing, washing dishes, and even going out in the rain. Tips for Keeping Your Cast Dry Take special care to keep your cast dry when you bathe or shower. Also take care if it s raining or snowing outside. To keep your cast dry: Wrap your cast in plastic wrap or one or more plastic bags. Use heavy tape to secure the plastic so that water won t leak in. But do not apply the tape directly to your skin. Don t soak your cast in water, even if it s wrapped in plastic. Cover your cast with waterproof clothing or plastic if you must go out in rain or snow. If Your Cast Gets Wet If your cast does get wet, dry it as soon as possible. To do this, use a hair dryer set to cool. Call your healthcare provider if your cast doesn t dry within 24 hours. 8 Cast Care
What Not to Do If your cast is damaged, it can t do its job of holding your injury in place. And the skin under your cast is easily hurt. To protect your cast and your skin: Don t stick things in your cast, even to scratch your skin. Objects put in your cast may get stuck. Also, your skin may be cut and become infected. If your skin itches, try blowing cool air into the cast with a hair dryer. Don t cut or tear your cast. Cover any rough edges of the cast with cloth tape. (You can buy this at a pharmacy.) Never try to remove your cast yourself. Don t pick at the padding of your cast. Padding protects your skin and must be kept intact. When to Call the Healthcare Provider Call your healthcare provider right away if any of these problems occur: Tingling or numbness in the injured body part Pain that worsens or that doesn t get better with medications Cast feels much too tight or much too loose Fingers or toes swell, feel very cold, or turn blue or gray Rubbing or irritation of skin in the cast Cast is damaged or cracked, or has rough edges that hurt Cast gets wet and doesn t dry within 24 hours Caring for Your Cast 9
As You Heal Your injured body part will hurt less and less as it heals. In the meantime, make yourself feel better by giving your injury special care. Take any pain medications as directed. Also, try the tips below. Rest Pain is your body s way of telling you to rest an injured area. Limiting your use of an injured body part helps it heal. So take it easy while you recover. Elevate Keep your injured body part higher than your heart. This reduces pain, swelling, and throbbing. Prop up an injured arm. Rest an injured leg on pillows or a footstool. Ice Ice your injury to reduce pain and swelling. Use a cold pack or bag of frozen vegetables. Putting a thin towel over the cast helps keep the cast dry. Ice helps most in the first 48 hours after the injury occurs. Do not ice for more than 15 to 20 minutes at a time. Exercise To help keep blood moving, wiggle any joints that are near (but outside of) your cast. These joints may include your toes, ankle, knee, elbow, or fingers. Your healthcare provider will tell you how often to do this. You may also be taught other exercises. 10 Cast Care
Removing Your Cast The day to remove your cast has come. But your recovery isn t over yet. Your bone is still growing stronger. Keep caring for your injury. And follow your healthcare provider s instructions until you re fully healed. How Your Cast Is Removed Your cast will be removed with a special saw that moves back and forth (oscillates). Your skin may tingle or feel warm while the cast is being sawed. Don t worry! The saw is designed to cut your cast without cutting your skin. After Your Cast Comes Off Don t be surprised if your injured body part looks a little different than it used to. It will return to normal over time. You may have: Weak Muscles The muscles around your injury may have shrunk. This is because they weren t being used while in a cast. As you start using them again, the muscles will get stronger. You may be given exercises to do to help. Dry Skin Skin that has been covered by a cast may be dry and flaky. Using lotion can help make your skin soft again. Your skin may also be tender and itchy. If needed, rub it with your open palm. Don t scratch! Swelling Since your injury is still healing, it may swell even after the cast is removed. To help reduce swelling, elevate the injury higher than your heart. If swelling continues, call your healthcare provider right away. As You Heal/Removing Your Cast 11
Getting Back into the Game Wearing a cast will help your injury heal correctly. Healing takes time. But caring for your cast and your injury will help your recovery go smoothly. Once your cast is off, keep caring for your injury as the new bone gets stronger. And be patient. Before long, you ll be back into the game! TAKE OUR PATIENT SURVEY. Help us help other patients. Please visit www.kramesurvey.com to provide your feedback on this booklet. This booklet is not intended as a substitute for professional medical care. Only your doctor can diagnose and treat a medical problem. 2014 Krames StayWell, LLC. www.kramesstaywell.com 800-333-3032 All rights reserved. Made in the USA. 12043 1312