Kaohsiung Armed Forces General Hospital

Pingtung Branch of Kaohsiung Armed Forces General Hospital

Cast Care Instructions for Patients

1.Purpose of a Cast

• To support, immobilize, and protect the injured area during fracture healing.
• To prevent or correct limb deformities.
• To allow the affected limb to rest during illness, promoting bone healing.

2.Care Instructions After Applying a Cast

• Initial Warmth:

A warm sensation for the first 10–15 minutes after applying the cast is normal, caused by the cast drying process.

• Drying the Cast:
  • Keep the newly applied cast exposed to air and allow it to dry naturally.
  • Drying time: Traditional plaster ~24 hours; resin cast ~3–4 hours.
  • Do not press, step on, or cover the cast with blankets or clothes before it is dry, to avoid deformation.
  • A fully dried cast is white, shiny, odorless, hard, and brittle.
  • A wet cast appears gray, dull, musty, and damp.
• Elevating the Limb:

Use pillows or a sling to keep the casted limb elevated above heart level to promote blood circulation and reduce swelling.

• Monitor Circulation and Sensation:
  • Daily check the fingers or toes for swelling, numbness, tingling, burning, coldness, or color changes.
  • If you notice pain, swelling, numbness, coldness, pale or bluish fingers/toes, inform your healthcare provider immediately.
• Itching:
  • Use cast-specific sprays or a cool air blower to relieve itching.
  • Do not insert any sharp objects (e.g., knitting needles, back scratchers, sticks) into the cast.
  • Do not paint the cast or cover it with plastic, as this blocks air circulation.
• Signs of Complications:

Report leakage, bleeding, burning inside the cast, foul odor, or moldy smell to your doctor.

• Rehabilitation Exercises:

Perform finger/toe movements, abduction/adduction, quadriceps contractions, ankle dorsiflexion and plantarflexion, etc., to improve circulation, reduce swelling, prevent joint stiffness, and maintain muscle function.

• Do Not Remove Padding:

Never remove the cotton lining inside the cast, as this may loosen the cast and damage the skin.

3.Seek Medical Attention Immediately If:

• Persistent or worsening pain.
• Swelling, pain, paleness, bluish color, or numbness in the fingers or toes within the cast.
• Foul odor or fluid leakage from the cast.
• The cast becomes too tight, too loose, deformed, or cracked.

4.Removing the Cast

Never remove the cast by yourself. The physician will remove it when appropriate.

5.After Cast Removal

• Cast Saw Vibration:

The cast saw may cause vibration but will not hurt the skin. No need to worry.

• Skin Care:

The skin may appear dry or flaky. Wash with mild soap and warm water, then apply lotion or petroleum jelly. Do not scratch the skin.

• Muscle Weakness or Joint Stiffness:

Discuss with your doctor and perform passive joint exercises, gradually increasing activity as tolerated.

• Getting Out of Bed:

Initially, getting out of bed may cause swelling or dependent edema. Reduce the duration at first, then gradually increase as tolerated.

Note: Always follow your healthcare provider’s instructions. Report any unusual symptoms promptly to prevent complications.