Caring for the Child in a Cast

Casts are made from many different types of materials and used on different parts of the body. A cast was put on your child so that the injured area could heal well. The care of the cast will vary slightly, depending on the type of cast that was put on.

Before the cast is applied, a synthetic padding material is used to protect the skin. (Some fiberglass cast material already contains a padding liner.) The cast is then put on over this padding. At first, the cast will feel warm; this will last for about 10 to 15 minutes. A plaster cast will remain damp for many hours, whereas a fiberglass cast will dry within 30 minutes. Do not put anything in the cast while it is drying or afterward. During the drying time, touch the cast as little as possible. If you have to touch the plaster cast, use the palms of your hands, not the fingers (Figure 1). Turning the child in a plaster body cast at least every 2 hours will help the cast dry. Do not use a heated fan or dryer. A regular fan can be used in humid weather to circulate the air.

Check the skin around the cast frequently. Notify your health professional at (phone number) if any of these occur:

If it is a leg or arm cast, check the color of the toes or fingers. They should be pink and warm to the touch. When the skin in these areas is lightly pressed and released, the skin color should return quickly. To help prevent swelling, raise the arm or leg in the cast above the level of the child’s heart (Figure 2) by resting the cast on several pillows or blankets. If an arm is in a cast, a sling helps support the arm during the day and pillows can be used at night. For leg casts, loosen the covers on the bed at nighttime and place some pillows by the feet to keep the blanket from putting pressure on the toes.

Some leg casts are made so that the child can walk with the cast. If this type of cast (i.e., weight-bearing) cannot be used, the older child can be taught how to walk with crutches. When crutches are needed, follow your health professional’s guidelines for the correct size and padding of the crutches.

The cast will be on for about 4 weeks. During this time, the child should exercise the joints and muscles that are not in the cast. Games such as “Simon says” can make movement fun. Your health professional can suggest some exercises for your child.

Skin Care

During the time the cast is on, special care is needed to keep the skin around the cast healthy. The back of the leg may be irritated when the child is in a short leg cast, and the skin between the thumb and the index finger is often a problem with an arm cast. If the plaster cast rubs against the skin, tape can be used to cover the rough edges of a cast. This is called petaling and involves these steps (Figure 3):

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