Purposes: 
  1. To support and protect fractures areas, or bones, tendons and ligaments that are injured or undergoing surgical treatments.
  2. To prevent and correct limb deformities.
 
Post orthopedic casting care: 
  1. 10~15 minutes after the plaster cast is applied, patient will experience a burning sensation in the treatment area, which is a normal phenomenon.Before the plaster dries, it should not bear weight.
  2. Check the end of the plastered limb every day for swelling, pain, paleness, and numbness.
  3. Smooth the rough edges of the plaster cast and apply cloth glue on the edge of plaster cast as needed to prevent cast from damaging skin due to friction.
  4. Observe whether there is any abnormality such as seepage of blood or other body fluid on the surface of plaster cast.
  5. When skin is itchy, patients can tap on the plaster cast or blow cold air into plaster cast, but should not insert any objects into plaster cast for scratching.
  6. Patients with plaster casts on upper limbs need to raise their limbs with an arm sling or a triangle bandage.
  7. Patients with plaster casts on lower limbs have to wear walking cast boots to keep plaster cast clean and prevent slippery. When patients get out of bed, they need to walk with crutches or walkers. Patients may feel congestion and swelling over limbs upon getting out of bed. Therefore, they should gradually increase the time spent out of bed and elevate their lower limbs during rest.
  8. The plastered limbs need muscle contraction exercise to prevent muscle atrophy, and the joints outside the plaster cast should be constantly active to maintain its maximum range of motion
 
Home care: 
  1. The plaster cast should be kept clean and dry. The limbs can be tightly wrapped with plastic wrap or plastic bag while bathing. If plaster cast accidentally gets wet, it can be blow-dried with cold air.
  2. Patients should continue rehabilitation exercise taught during hospitalization.
  3. The plastered limbs should be elevated to reduce swelling.
  4. Patients should not remove plaster cast by themselves, so that therapeutic effect can be maintained.
  5. No items should be inserted into plaster cast.
  6. If any of the following abnormalities occur, patients should go to hospital immediately for medical attention.
    1. Abnormal swelling, tingling, numbness or coldness over plastered limbs.
    2. Broken or loosened plaster cast.
    3. A burning sensation or unusual odor inside plaster cast.
 
Precautions after plaster cast removal: 
  1. When plaster cast is being sawn off, the patient will experience compression over the limb, but it will not cut the skin. Please remain calm and maintain the limb in a steady position.
  2. After plaster cast is removed, the skin will be dry and peeling. It can be cleaned with neutral soap and warm water.
  3. After plaster cast is removed, the patient may experience muscle weakness and joint stiffness. Activity of the affected limb should be gradually increased.
 
References
  1. Lin, S., Wu, C. E., Lee, H. H., Chiu, P. Y., & Lo, S. F. (2017). Care for Patients with Skeletal, Muscular, and Joint Disease. In Hwu, Y. J. (Eds.), Medical- Surgical Nursing (5th ed., pp. 912-920). Taipei City: Farseeing Publishing.
  2. Mersal, F. A., Mersal, N. A., & Hussein, H. A. (2017). Effect of Educational Guidelines for Prevention of Immobilization Complications on Caregivers Performance and Patients Functional Condition. American Journal of Nursing, 5(2), 32-41. doi:10.12691/ajnr-5-2-1
  3. Nguyen, S., McDowell, M., & Schlechter, J. (2016). Casting: Pearls and pitfalls learned while caring for children's fractures. World Journal of Orthopedics, 7(9), 539-545. doi: 10.5312/wjo.v7.i9.539
  4. Paul, S., Richard, G. B., James F. W.(2018).Contributor Disclosures Patient education: Cast and splint care (Beyond the Basics). UpToDate. https://www.uptodate.com/contents/cast-and-splint-care-beyond-the-basics
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