1. Keep the edge of the plaster flat to prevent skin damage from friction.
2. If your skin is itchy, pat the cast lightly or blow cold air from a hair dryer into it. To avoid skin damage, never insert anything into the cast to scratch it.
3. Please check the surface of the cast every day for any fluid or blood.
   If you notice swelling, pain, pale or cold skin, decreased sensation, or numbness or tingling at the end of the casted limb, please inform the healthcare staff immediately.
4. Rehabilitation exercises:
   1. The limb with a cast must undergo muscle contraction exercises. For example, patients with lower limb casts must perform quadriceps exercises: press down on the knees and contract the thigh muscles to prevent muscle atrophy.
   2. Joints not enclosed in the cast, such as fingers and toes, may move according to the instructions of healthcare staff to help maintain the maximum range of motion.
5. Precautions for bed rest and activities:
   1. When lying down, elevate the casted limb with a pillow to promote blood circulation and reduce swelling.
   2. Follow your doctor's instructions and avoid putting weight on the casted limb, such as lifting or walking with heavy objects.
   3. For upper limb casts, support the affected arm with your unaffected hand or use an arm sling as directed by your physician when getting out of bed.
   4. For lower limb casts, wear a cast shoe when getting out of bed to keep the cast clean. Use crutches or a walker to assist with walking and to prevent falling (Figure 1).
   5. Patients with lower limb casts may experience congestion and swelling when getting out of bed. Therefore, gradually increase the time spent out of bed and elevate the casted limb during rest periods to alleviate swelling.
      

Figure 1
For patients with lower limb casts, when getting out of bed, it is essential to wear a cast shoe and use crutches or a walker to assist with walking.

Home Care

1. The cast should be kept clean and dry. When bathing, tightly wrap the limb with a plastic bag or use a cast waterproof cover (Figure 2) to prevent it from getting wet. Avoid wetting the cast, but if it accidentally gets wet, you can use a hairdryer on a cool setting to dry it.
   
   Figure 2
   Cast Waterproof Cover
   

2. It is important to keep the casted limb elevated to reduce swelling and continue performing the rehabilitation exercises taught during your hospital stay.

3. Do not insert any objects into the cast, and do not attempt to remove the cast yourself, as it may interfere with the effectiveness of the treatment.

4. If you experience any of the following abnormalities, please seek immediate follow-up at the orthopedic clinic: 

   1. Unusual swelling, sharp pain, numbness, or a sensation of coldness in the casted upper limb.

   2. Cast breakage or loosening.

   3. Sensation of heat or an unusual odor within the cast.

Post-cast removal considerations:

1. When the cast is being removed with a saw, you may feel vibrations and pressure, but it will not cut the skin, so there's no need to worry.
2. After cast removal, the skin may be dry and flaky, which can be cleaned with mild soap and lukewarm water.
3. Following cast removal, you may experience muscle weakness and joint stiffness. It's essential to gradually increase the activity of the affected limb.