CARE OF CASTS
A cast immobilizes a part of the body that has been injured. Casts are used most commonly after bone fractures.
Casts are usually applied by placing a splint along the injured part and wrapping it with gauze saturated with plaster of Paris. Before the injury heals, it may be necessary to change the child's cast one or more times. The time needed for healing determines how long a cast remains in place. Some casts are needed for only 2 weeks. Others are necessary for several months.
X-rays through your child's cast reveal whether bone alignment is satisfactory. They are also used in later stages to check for signs of healing.
AFTER YOU LEAVE THE DOCTOR'S OFFICE Don't allow pressure on any part of the child's cast--no matter what type of casting material was used--until it is completely dry. Any depression that develops will create pressure on the skin underneath, making ulcer formation likely. Drying time varies depending on the type of material used, thickness of the cast, temperature, and humidity. Drying can require 24 hours or longer.
Keep the child's cast dry, especially at first. If the cast accidentally gets wet and a soft area appears, return to the doctor's office, emergency room, or outpatient surgical facility for repairs.
Whenever possible, raise the body part enclosed in the cast. This decreases the chance of tissue swelling inside the cast. Prop a leg in a cast on a pillow when the child is in bed, and on a footstool or chair when the child is sitting. Prop an arm in a cast on a pillow placed on the chest. Elevate the foot of the bed at night for any injury requiring a cast below the child's abdomen.
SWELLING INSIDE A CAST
No matter how carefully the injured tissues are handled, and no matter how expertly the cast is applied, swelling sometimes occurs inside a cast. Swelling should be reported immediately to the doctor. The following are common symptoms and signs of swelling:
Severe, persistent pain.
Change in color of tissues beyond the cast, such as a change to blue or gray under the fingernails or toenails.
Coldness of the tissues beyond the cast, even though the rest of the child's body is warm.
Numbness or complete loss of feeling in the skin beyond the cast.
Feeling of tightness under the cast after it dries.
For a leg cast, inability to raise the big toe.
INFECTION INSIDE A CAST
Sometimes the injured area becomes infected during healing. Detecting the infection in early stages may be difficult if the infected area is covered by a cast. Infection should be reported immediately to the child's doctor. Following are common signs and symptoms of infection:
Leakage of fluid through the cast.
Pain or soreness of the skin under the cast.
Fever accompanied by a general ill feeling.
ITCHING INSIDE A CAST
Itching can be a maddening problem for a child with a cast -- especially during hot weather. Even if it is possible to reach the itch, urge your child not to scratch the skin inside the cast. Because the skin is in a hot, moist environment, it is very vulnerable to damage. Scratching is more likely to injure the skin than under normal circumstances. If no incision was made, you may sprinkle cornstarch into the cast to relieve itching. If an incision was made, consult your doctor for pain medication. Itching is a form of mild pain.
BATHING WITH A CAST
Your child may find bathing difficult when wearing a cast. The cast must be kept dry at all times, so the child should not take showers. If the cast is on a limb, such as the arm or leg, the child may take tub baths. Position a chair or other support by the tub so you can prop the injured part out of the water while the child is bathing. If the cast is on the trunk of the body, your child should take sponge baths until the cast is removed.