Rule #1: Keep the cast clean and dry
It is very important to keep your cast dry when bathing or showering. Although fiberglass is resistant to water damage, your cast should not get wet. The cotton lining under the fiberglass or plaster can become wet, and may cause skin irritation or skin breakdown. If the cotton lining gets wet, try to dry it with a blow dryer on a low, cool setting. If you are unable to dry it, or the skin becomes itchy, you should advise our office of this condition as soon as possible.
If you have a cast on your leg and it is wet outside (rain, puddles, melting snow, etc.), put a bag over the cast to keep it dry. If it is a walking leg cast, put the shoe on OVER the cast and the bag. Do not put the bag on the outside of the cast and cast shoe, as the bag can be slippery and cause further injury.
Waterproof casts: Waterproof casts are not indicated for several different types of fractures. They are also not appropriate for certain body parts. However, if you have been given a waterproof cast, then you are able to get this cast wet. However, it is still very important to make sure that all of the water drains out of the cast after getting wet each time. This can be accomplished by simply holding the cast vertically to allow the water to drain out adequately. Another recommendation is to rinse each cast out with clean tap water after any exposure to chlorinated water (swimming pools, hot tubs, etc.).
Rule #2: Do not insert anything into the cast
You should never insert anything into the cast to scratch. If you do so, you risk cutting your skin beneath the cast, which could result in an infection. Also, if an item does become lodged or falls inside the cast, please notify us immediately. This can cause skin irritation and skin breakdown.
Rule #3: Elevate
Swelling around the area of the broken bone can increase anywhere from one to three days following the initial injury. This will make the cast feel tighter, and will make the pain worse.
Swelling is best reduced by elevating the cast above heart level. This generally required you to be lying down. (A sling is not high enough if you are sitting, and a footstool is not high enough for a leg cast.) Think of water running downhill from the fractured bone to the heart when trying to decide how to elevate it. Use up to five pillows for a leg cast, and up to three pillows for an arm cast. When elevating for a leg cast, pillows should be placed under the leg and calf. This leaves the heel free in order to prevent sores from developing. Elevation should continue until the swelling and the tightness in the cast goes away. Gently exercising the fingers or toes will also help to reduce swelling.
Rule #4: Ice
Icing is optional, but it may help to decrease pain. If you have a recent injury, place a well sealed bag of ice on the injured extremity for 20-30 minutes. You can do this 3-4 times per day for the first 24-48 hours after the injury. Put a towel on the cast, and place the bag of ice on top of the towel. Be careful not to get the cast wet!
Rule #5: Wear the cast shoe
If you have a walking cast, you must always wear the cast shoe! Without it, the cast is very slippery to walk on. The bottom of the cast will break down easily if she shoe is not worn at all times. If the cast does break down, this may require an office visit for removal and reapplication of the cast.
Rule #6: Questions or concerns?
There are several signs that may require emergent (immediate) medical attention. You should contact us at either our Denver office at (303) 861-2663 or our Sky Ridge office at (720) 979-0840 if you develop:
- Severe pain not relieved by the medication prescribed for you
- Persistent burning under the cast
- Numbness or tingling not relieved by 30-45 minutes of elevation
- Extreme tightness under the cast, or excessive swelling below the cast
- Broken or damaged cast (please do not attempt to remove the cast)
- Any abnormal skin discolorations, such as blue or purple skin
Remember: If you have any questions, or are afraid that you might have a problem, we want to hear from you! Do not hesitate to call. If you need assistance outside of our normal business hours, please call our office. You will be directed to our after-hours answering service, and they will get you in touch with an on-call provider who can assist you.