Cast Care

Follow Up in 5 to 7 days in the Orthopaedics Clinic

Your child's cast is a solid mold of fiberglass or plaster (or sometimes both). It will harden before you leave the Emergency Department. It may take up to two days for the cast to completely dry.

The cast helps keep your child's injured arm or leg properly aligned and protect the bone while healing occurs.

You will not be able to remove the cast yourself.

Basic cast care

• Follow the doctor’s instructions for when your child can first put weight on the cast.
• For the first three days, prop your child’s casted arm or leg on a chair or pillow when sitting or lying down. This will help decrease swelling.
• Have your child wiggle their fingers or toes in the casted arm or leg once an hour during the day. This improves blood flow to the injured limb.
• You can give acetaminophen (Tylenol) or ibuprofen (Motrin) as needed for pain.
• Your doctor might give your child a prescription to use for breakthrough pain. Use this as directed.

Showering with a cast

• Your child’s cast is not waterproof.
• Keep the cast clean and dry. Never put the cast under water.
• Cover the cast with a heavy plastic bag when your child showers or bathes. There are also special showering bags for casts.
• Wrap the bag tightly around the arm or leg above the cast. Tape it with waterproof tape.
• Remove the bag right after the shower.
• If the edges of the cast get slightly wet, keep them uncovered until they dry.
• Use a hair dryer on a COOL setting to help dry the cast.
• Call your doctor if the cast gets very wet.

Skin care

• Doctors usually cover the edges of the cast with a soft fabric wrap. Sometimes this fabric gets worn or torn.
• You can add moleskin to keep the cast edges smooth. You can buy moleskin at most drug stores.
• Check the skin around the cast once in the morning and once at night. Look under the edges of the cast. There should be no red, irritated, swollen, or broken skin.

Itchy skin

• The skin under the cast can get itchy. Never put anything down into the cast to scratch.
• For itchiness, use a hair dryer on a cool, low setting and blow air into the cast.
• You may use diphenhydramine (Benadryl) for itching.

Seek care right away

Seek medical care right away if your child has:

• Numbness or tingling that doesn't go away with a change of position.
• Severe pain when moving fingers or toes of the casted arm or leg.
• Extreme soreness, redness, or blueness of fingers or toes.
• Coolness of the casted arm or leg that does not go away.
• A bad smell or drainage from the cast.
• A decreased ability to move fingers or toes.
• Severe itching that doesn't go away.
• Red, broken, or swollen skin around or under the cast.
• Cracks, splints, or softening of the cast.
• A fever above 101°F (38.5°C) by mouth lasting more than one day.

Scheduled follow-up care

Your child received care by Orthopaedics at UPMC Children's Hospital of Pittsburgh.

• Follow up in 5 to 7 days at the Orthopaedics Clinic. If you prefer, you may follow-up with your own orthopaedic doctor.
• The phone number for the Orthopaedics Clinic is 412-692-5530. Please call on the next business day between 9 a.m. and 5 p.m. to schedule your child’s follow-up appointment. We do not see patients without an appointment.
• After 5 p.m. on weekdays or on weekends and holidays, you can reach the hospital operator at 412-692-5325. Ask to speak with the orthopaedics resident on-call for any urgent questions.

Crisis management services

A crisis can be anything from feeling lonely and needing to talk, to feeling overwhelmed with life.

Call the resolve crisis network at 1-888-7 YOU CAN (1-888-796-8226), 24 hours a day, 365 days a year, for:

• One-to-one phone counseling.
• Walk-in center information.
• A mobile counselor that will come to where you are — anywhere in Allegheny County.

The resolve crisis service is available to anyone regardless of age or ability to pay.