Cast care and Mobility Changes What is a cast?

Cast care and Mobility
Changes
What is a cast?
A cast is used to keep a part of the body
(usually an arm or a leg) from moving. This
may be done to help broken bones heal or to
put the body part in the correct position.
The child’s skin is protected with a smooth
lining material before the cast is applied.
Your child’s cast is made of:
fiberglass
plaster
What can I expect after the cast is
applied?
Fiberglass casts dry within a few hours.
Plaster casts take 1 to 3 days to dry
completely. Handle the wet cast with your
palms, not your fingers, to avoid dents.
The cast will feel heavy and awkward at
first. Your child may feel uncomfortable
and tired for a few days from the weight of
the cast.
How do I care for the cast?
Do not let the cast get wet. A wet cast will
irritate the skin, soften, crack, and fail to
hold the arm or leg in the correct position.
If the cast gets wet, call the clinic. If it just
gets damp, dry it with a hair dryer on the
coolest setting.
Check the cast daily for cracks, dents,
softening, drainage, or changes in tightness.
Keep it clean. Do not apply paint or keep it
covered with plastic. These materials stop
air from getting through the cast.
If the cast is made of plaster, you may clean
it with a small amount of toothpaste or dry
white cleanser (Ajax® or another brand) on a
slightly dampened cloth. Rub gently to
remove the dirt. On fiberglass casts, dirt can
be washed off with a damp cloth. Dry it
well with a hair dryer set on the coolest
setting. Never use a hair dryer on a hot
setting because it can burn the skin.
Any rough edges of a cast can be covered
with pieces of plastic tape, or a fabric tape
called moleskin, cut into petal shapes.
Change the tape as needed.
How can I care for my child?
If your child has a cast for an injury:
Raise the arm or leg on pillows well above
heart level whenever your child is lying
down to reduce swelling. When your child
is up, keep an arm cast in a sling.
Pain
Give medicine to relieve pain as prescribed.
Eating
Constipation may become a problem for
your child if activity level has decreased.
Encourage drinking more fluids, especially
during hot weather. Your child should eat
more fruits and vegetables.
Cast care
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Skin care
Sponge baths are best. Be careful to keep
the cast dry. If a tub bath is needed, wrap
the cast with 2 or 3 layers of plastic wrap or
shrink wrap (less expensive and available at
home improvement stores). Then put a
plastic bag over the cast and secure it with
waterproof tape or more plastic wrap or
shrink-wrap. Keep the cast raised and out of
the tub.
Do not insert anything into the cast to
scratch the itch. Sometimes rubbing inside
with fingertips (not fingernails) will help.
For severe itching, check with your doctor
about a medicine to relieve it.
If the cast limits movement, turn your child
at least every 2 hours when awake, and as
often as you can at night, for comfort and to
prevent pressure sores.
Activity
With a leg cast, separate the toes after the
bath to better allow air-drying. If the skin
between the toes remains damp, apply
rubbing alcohol or witch hazel with cotton
swabs (such as Q-Tips®).
Check circulation every four hours for the
first 12 hours, and then twice a day. Toes or
fingers and nail beds should be warm and
normal in color. Your child should be able
to wiggle them easily. A sock or knit cap
can be worn over the toes to keep them
warm, and to keep dirt and gravel from
getting into the cast.
Check the skin twice a day. Press on the
skin around all the cast edges to look and
feel for reddened areas, sores, or objects
inside.
Do not use lotion or powder inside the cast
or on the skin at the cast edges. Powder can
cake, and lotion will soften the skin, making
sores more likely.
Do not let your child put anything into the
cast. Even a small object inside the cast can
cause sores.
Itching is very common. It often comes and
goes. To lessen itching, keep the area inside
the cast as dry and cool as possible.
Sometimes distraction or blowing cool air
under the cast may help.
The doctor will tell you what activities are
okay. Do not let your child stand or walk on
a leg cast unless the doctor has given
permission. See the education sheet,
“Crutches.”
When walking is allowed, use a cast boot to
keep the cast dry and clean, and to prevent
slipping. You can also use slipper socks
with rubber on the bottoms, or apply rubber
coating to an old pair of socks or slippers.
What can I expect when the cast is
removed?
A cast cutter will be used to remove the cast.
Instead of spinning around, the blades
vibrate side to side and make a loud buzzing
noise. Your child will feel the vibration and
a warm sensation. The cutter will not cut
your child, but it will feel like the skin is
being touched.
After the cast is off, the skin looks scaly.
Your child’s arm or leg will look thinner
than usual because of the lack of movement.
The skin will be tender. If it itches, rub
gently with fingertips. Avoid scratching.
Cast care and Mobility Changes
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When should I call the clinic?
•
something has dropped into the cast and
you cannot get it out.
•
the cast is cracked, dented, softened.
•
the cast has gotten fully wet.
•
skin around the cast edges has redness
that does not go away within 30 minutes
after changing positions.
•
you notice new signs of skin irritation
such as rashes, sores, blisters, or bruises.
•
unusual drainage on the cast or an
unexplained bad smell.
•
if any of these problems are not relieved
by raising the cast above heart level:
- cast looks tight and skin is swollen at
the cast edges.
- swelling, tingling, or numbness in
toes / fingers.
- toes / fingers are reddish, bluish or
cold to the touch (after cast is dry).
- hard, contracted lumps of muscle.
- pain that does not go away.
When children are in a cast or must stay in
bed, the change in mobility can be hard for
them and their family. It is normal for
children to move and play. If they can’t
move as much as they are used to, they may
feel frustrated or angry. This can affect the
whole family.
How can I help my child?
Feelings need to be expressed. Encourage
children to tell you how they feel, or to draw
pictures about it. You can also help reduce
restlessness and frustration, by helping
children focus on what they can do, for
example:
• Use interactive books such as pop-up,
lift-the-flap, or search-and-find types.
•
•
Throw a foam ball or basketball.
Squeeze playdough or a small, soft ball.
Help your child be as independent as
possible. Have needed or special things
within reach. For example, provide a
container to hold your child’s toys and
games.
Help your child move as much as possible
within the limits that have been set. Change
positions by using a beanbag chair. Use a
wagon or reclining wheelchair to help your
child get around. Take short trips to the
mall, zoo, park, or to the library for story
time.
Provide activities
The following activities will help keep
children of different ages entertained and
active.
Infants and toddlers
Children in this age group who have just
become more independent through crawling
and walking can find limited mobility
especially hard. These ideas can help:
• balls
• books
• mobiles
• pop-up toys
• pounding toys
• simple puzzles
• shape sorters
• stuffed animals
• toy mirrors
• xylophones
With supervision, use:
• bubbles
• Mylar balloons (never latex)
• water toys
Cast care and Mobility Changes
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Preschoolers
Preschoolers like to play in ways that give
them choices and the chance to be in
control. Be sure to schedule rest time along
with play time.
• board games
• coloring books
• crayons
• Duplos
• Etch-a-Sketch
• foam balls
• magnadoodle
• musical instruments
• Paint-with-Water books
• play people
• pounding toys
• punching bags
• puppets
• puzzles
• sticker books
With supervision, use:
• beach ball
• bubbles
• Mylar balloons (never latex)
• playdough
• water toys
• water color paints
School-age children
Friendship is important, so encourage
friends to visit. If a video camera is
available, a teacher could help students
make a video of the class.
• board games
• books
• computer games
• crayons and markers
• Etch-a-Sketch
• felt boards
• foam balls
• hand-held games
•
•
•
•
•
•
•
•
•
•
•
•
jigsaw puzzles
Koosh balls
Legos
Magnadoodle
Mylar balloons (never latex)
paints
paper or foam airplanes
paper dolls
playing cards
punching bags
puppets
puzzle books – crossword, Sudoku, word
seearch
•
•
•
•
•
Silly Putty
stuffed animals
tape recorders
Velcro target
video games
With supervision, use:
• beach ball
• bubbles
• car models
• clay
• craft projects
• fingerpainting
• library visit
• paint-by-number
• playdough
• rug hooking
• water play
• water color paints
What else do I need to know?
Never have latex balloons around young
children. If they burst and pieces are
swallowed, they cause choking. Use Mylar
balloons instead.
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Questions?
This sheet is not specific to your child, but
provides general information.
For more reading material about this and
other health topics, please call or visit the
Family Resource Center library, or visit our
Web site: www.childrensmn.org.
Children’s Hospitals and Clinics of Minnesota
Patient/Family Education
2525 Chicago Avenue South
Minneapolis, MN 55404
11/09 Copyright
Cast care and Mobility Changes
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