The Hard Facts of Casting:
Protecting injured bones

Casting techniques play an important role in the healing of an injury. A cast provides external support or a protective covering that reduces recovery time and aids in the proper alignment of bones. Casts are generally applied to fractured limbs, but they also help in the correction of pediatric deformities, such as club foot, a congenital (present at birth) foot deformity.

Casting Materials
Plaster and fiberglass are the most common materials used in casting today. Plaster, pliable and economical, is often used as a temporary measure for a fracture before your doctor decides on the best treatment for your injury. Stronger and more water-resistant than plaster, fiberglass dries much faster and is much lighter, allowing for quicker and easier mobility for weight-bearing injuries. The padding placed under the cast allows normal body moisture to be trapped and provides cushioning from the hard cast. It also provides protection from the cast saw blade, which, if used improperly, can cause burns or scrapes to the skin during cast removal. Silicone cast padding can be used as a method of waterproofing the inside of a cast. Although more expensive than cotton, silicone padding reduces the chance of skin irritation, odor, and itching by keeping the padding dry. Covers designed to protect a cast during bathing help the patient avoid wetting the outside of the cast.

Dos and Don'ts

Most injuries are treated initially with temporary splints for the first few days to allow any swelling to subside before applying the cast. After the cast is applied, you should continue to watch for any swelling. Severe swelling, causing loss of feeling and discoloration in fingers and toes, indicates loss of circulation. The swelling can be kept to a minimum by elevating your injured arm or leg above your heart (Fig. 1) and icing the injured area. Ice may be applied directly around the cast on the exposed skin (Fig. 2). If swelling persists, your doctor may split the cast on the sides to provide relief.

You should never pour powder into your cast to reduce sweating and to cover odors. Plaster and fiberglass are breathable materials that do not need powder, which only temporarily relieves dampness and often adds to the odor.

Never place a sharp item inside your cast. Scratching itchy skin with a clothes hanger, nail file, or other object can cause breaks in the skin or tear surgical incisions, thereby, increasing the chance for infection.

Cast Removal
Apply a strong sun block during the summer months after having a cast removed. After weeks of being covered, sensitive skin can easily burn and may create more prominent scar coloration.

After the cast is removed, dry, flaky skin can be washed and treated with skin lotion. You may experience some mild pain and stiffness, and your muscles may appear smaller due to the lack of use. The condition of your injured limb will gradually return to normal with regular use and appropriate physical therapy. Slowly return to your daily activities. If you wore a cast for 4 to 6 weeks, then you may expect your recovery to take 4 to 6 weeks.

Taking care of your protective cast usually results in a successfully healed fracture, and keeping a good attitude will help the time to pass more quickly.

Jay Graham, OTC
Columbus, Georgia