Plaster casts are used to support and protect fractures, injured tendons and ligaments or post-operative repairs. Also, it can be used to prevent and correct limb deformities..
Post orthopedic casting care:
- 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.
- Check the end of the plastered limb every day for swelling, pain, and paleness, coldness, numbness and tingling.
- Smooth the rough edges of the plaster cast to prevent cast from damaging skin due to friction.
- Observe whether there is any abnormality such as body fluid or seepage of blood on the surface of plaster cast.
- When skin is itchy, patients can pat on the plaster cast or use a hair dryer on cool setting to blow into plaster cast. Do not insert any objects into plaster cast for scratching, in order to prevent skin damaged.
- Patients with plaster casts on upper limbs need to raise their limbs with an arm sling or a triangle bandage.
- 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.
- The plastered limbs need to do muscle contraction exercise, in order to prevent muscle atrophy, and the joints outside the plaster cast should be constantly active to maintain its maximum range of motion
- The plaster cast should be kept clean and dry. The limbs can be tightly wrapped with plastic bag or cast & bandage protector waterproof cover while bathing (figure 1). Avoid the plaster cast gets wet.
- If plaster cast accidentally gets wet, it can be blow-dried with cold air.
- Patients should continue rehabilitation exercise taught during hospitalization.
- The plastered limbs should be elevated to reduce swelling.
- Patients should not remove plaster cast by themselves, so that therapeutic effect is not influenced.
- No items should be inserted into plaster cast.
- If any of the following abnormalities occur, patients should return to the orthopedic clinic immediately.
- Abnormal swelling, tingling, numbness or coldness over plastered limbs.
- Broken or loosened plaster cast.
- A burning sensation or unusual odor inside plaster cast.
Precautions after plaster cast removal:
- 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.
- After plaster cast is removed, the skin will be dry and peeling. It can be cleaned with neutral soap and warm water.
- After plaster cast is removed, the patient may experience muscle weakness and joint stiffness. The activity for affected limb should be gradually increased.
- Althoff, A. D., & Reeves, R. A. (2021). Splinting. In Stat Pearls.https://www.ncbi.nlm.nih.gov/pubmed/32491605
- Nemeth, B., & Cannegieter, S. C. (2019). Venous thrombosis following lower-leg cast immobilization and knee arthroscopy: from a population-based approach to individualized therapy. Thrombosis research, 174, 62-75.https://doi.org/10.1016/j.thromres.2018.11.030
- Paul, S.,Richard, G. B., James, F. W.(2018).Contributor Disclosures Patient education: Cast and splint care (Beyond the Basics).Up To Date. https://www.uptodate.com/contents/cast-and-splint-care-beyond-the-basics
- Piyapittayanun, P., Mutthakalin, K., Arirachakaran, A., & Kongtharvonskul, J. (2019). Comparative outcomes of foot cast and short leg cast in pseudo-Jones avulsion fracture: a single blinded randomized controlled trial. Journal of foot and ankle research, 12(1), 1-8.https://dx.doi.org/10.1186%2Fs13047-019-0359-5