Caring for your Plaster Cast
Welcome
This information leaflet provides advice on caring for your plaster
cast. Every case is individual, the Casting Practitioner will advise you
according to your individual needs.
There are a number of major points you should observe
whilst in your plaster cast:
Swelling
Does your limb feel/look swollen? High elevation of the
limb is important to keep the swelling to a minimum.
Colour
Is the colour of each finger/toe nail normal for you? Slight
duskiness or reddening of the toes is not uncommon
when your leg is hung down, but the normal colour
should return when you put your leg up.
Sensation Is the feeling normal in each finger/toe? Are there any
areas of numbness or pins and needles?
Movement Can you move each finger/toe ie fully stretch and bend
each one?
Pain
Are your painkillers effectively relieving your pain? Any
increase in pain (despite taking pain killers) should be
reported.
Skin Care If you are a diabetic please mention this to the doctor
during your consultation as you may require some
adjustments to be made to your plaster cast.
Blood clots(Deep vein thrombosis)
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What is a blood clot?
When you are injured or have an operation your blood clots naturally
to help prevent you losing too much blood. During periods of
prolonged immobility, a blood clot may form inside a blood vessel. If
this happens in a deep vein it is called a deep-vein thrombosis (DVT).
You may not notice you have a DVT. However, a DVT usually causes
pain, swelling and redness in the limb.
What can I do to help reduce my risk?
If you are able to, walk around as often as you can. If you have to stay
in bed or in a chair, try to move your feet and legs. Do not cross your
feet or legs.
Drink plenty of water to avoid becoming dehydrated. A member of
the healthcare team will advise you on how much and when you can
drink.
If you become short of breath, or have pain in your chest or upper
back, or cough up blood you should go to your nearest Emergency
Department or call an ambulance.
Veins carry blood from your muscles back to your heart and lungs.
Occasionally a blood clot can move through your veins in to your
lungs. This is called a pulmonary embolism, which is a serious
problem and can even cause death.
DVT and pulmonary embolism are together referred to as venous
thromboembolism.
For patients treated in a plaster cast
Blood clots can develop in the lower leg, due to immobility following
an injury or surgery. If you experience pain in the calf, which does not
go away, please contact either the Fracture Clinic, the Plaster Room,
your GP or the Emergency Department.
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Please contact us if you have any questions or concerns
Telephone 01270 612242 (direct dial).
In addition to these points please notify the Plaster Room staff
immediately if any of the following problems occur:
• Any persistent burning sensation under the cast
• Soreness or rubbing under the cast
• Any offensive smells coming from the cast
• Staining or leaking through the cast from a wound discharge
• The cast becomes broken, soft, dented or loose
• The cast becomes wet. (Use only an approved waterproof cover.
Contact numbers on page 10).
Please DO NOT attempt any of the following:
• Do not remove your cast or attempt to modify it in any way
• Do not attempt to ease your itching by poking anything down the
cast. You may damage your skin
• Do not apply any external heat to aid drying of your cast
• Do not stand on your leg cast until advised to do so by
your Doctor
• Do not wear nail polish whilst in your plaster cast as it is important
that you regularly observe the colour of your nails
• Do not wear finger or toe rings whilst being treated in a plaster cast.
4
Wrist/arm injuries
• Only wear a sling until you get home (unless advised to do
otherwise by your doctor or nurse)
• Keep your arm elevated as often as possible, ideally above the
level of your heart. This will help to reduce swelling and pain.
• Do the following exercises at least 20 times every hour (whilst
awake)
1. Make a tight fist, then straighten and spread your fingers
as wide as possible
2. Move your thumb around in a circle
Stretch
Spread
Make a fist
Touch tip of
fingers with thumb
3. Bend and straighten your elbow
4. Move the whole arm in a circle (to move the shoulder joint)
5. Touch the back of your head with the injured arm.
By doing these exercises regularly you will help
to speed your recovery
5
Leg injuries
• Try to keep your leg elevated as often as possible. When seated,
try to elevate your leg above the level of your hip. When lying
down, your leg should be elevated above the level of your heart.
Pillows and cushions can be used to support your leg
• Do not walk on your leg cast, unless you have been advised to do
so by your doctor. A cast shoe will be given to you for this purpose
• Keep your hip joint mobile
• Do the following exercises at least 20 times every hour (whilst
awake).
Below knee casts
1. Fully bend and straighten your knee
2. Move your toes up and down.
Above knee casts/cylinder casts
1. Move your toes up and down
2. Tighten and relax your thigh muscles inside the cast
3. If your ankle is free from plaster, allow your ankle to move
up and down, and around in a circle.
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By doing these exercises regularly you
will help to speed your recovery
What is a pressure ulcer and how they develop?
A pressure ulcer is localized injury to the skin and/or underlying tissue
usually over a bony prominence, as a result of pressure. Pressure
ulcers can develop when pressure is applied to an area of the skin
over a period of time. The extra pressure disrupts the flow of blood
through the skin. Without a blood supply, the affected skin becomes
starved of oxygen and nutrients and begins to break down.
Who is at risk of developing pressure ulcers?
People are at risk of developing pressure ulcers if they have difficulty
moving and are unable to easily change position while seated or
in bed. Therefore the risk of developing a pressure ulcer could be
increased for people who are in a plaster cast.
To reduce the risk we advise:
• The position of the plaster casted limb must be changed frequently
• Ensure the top and bottom of the cast is not rubbing or leaving red
marks on the skin
• Ensure all toes/fingers are able to move freely
• Regularly change your position, turn at least every 2 hours
• If you are in a leg cast and turning on your side, place a pillow in
between the knees to prevent the cast rubbing on the other leg
• Do not rest the leg on the heel for long periods, to relieve pressure
from the heel place a pillow length ways so the heel is floating.
Immediately contact Fracture Clinic Monday-Friday 9am-5pm or the
Emergency Department out of Fracture Clinic hours if you experience
any of the following:
• Feeling a rubbing or a blister like pain or any discomfort within the
cast
• Complaining of something wet or sticky inside the plaster cast
7
• If the plaster develops a smell
• Any staining developed on the outside of the cast
• Areas of pain or local heat.
Nursing home/Residential care:
• Ensure 2 hourly repositional changes and document this on a
repositioning chart
• Ask the patient if the cast is comfortable.
Your next clinic appointment
• We advise that you take your usual pain killers 1-2 hours before
your clinic visit, as we may need to change or modify your plaster
cast
• If your leg has been in plaster we would also advise you to bring a
comfortable shoe and a walking aid, if you have one, to your clinic
appointment in case your plaster cast is removed
• Wear loose clothing around the affected limb so that your cast can
be easily checked during your hospital appointment.
During your appointment you may need to visit the X-Ray Department
and the Plaster Room as well as seeing a doctor. Therefore, your
attendance at the clinic may be lengthy so please allow plenty of time
for your visit.
Sick NotesPlease ask the doctor in clinic if you require a sick note
for work.
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What to expect when your plaster cast is removed
• You will probably experience slight discomfort and stiffness
afterwards
• Your limb may feel weak due to loss of muscle tone whilst in the
plaster
• Some bruising may still be visible
• It is normal to experience slight swelling of your limb for some time
after cast removal
• You may need to continue using a walking aid for 1 – 2 weeks after
your cast has been removed.
You should continue with the exercises to ease stiffness until you feel
that you have achieved normal mobility. If necessary the hospital
doctor may refer you for specialist physiotherapy.
If any of these symptoms are prolonged or if you are concerned,
please contact the Plaster Room.
The Plaster Room offers an appointment only system.
If you wish to have your cast checked please
contact the Plaster Room direct dial telephone number
01270 612242.
We are available Monday – Friday 9.00am to 5.00pm
If you require advice out of these hours, please
contact the Emergency Department.
Direct number 01270 612187 or 01270 612160
9
1 in 3 women and 1 in 10 men will break a bone due to
Osteoporosis, (National Osteoporosis Society, 2003).
Osteoporosis is largely a preventable and treatable
disease. If you think you may be at risk please
mention this to your doctor during your consultation.
Some useful telephone/e-mail addresses
•
Limbo Waterproof Plaster Cast Covers (for baths/showers)
Tel: 01243 573417
e-mail: [email protected]
Website: www.limboproducts.com
•
Aquashield Plaster Cast Covers (for swimming)
Tel: 01912 769602 / 769604
e-mail: [email protected]
Website: www.peacocks.net
• Red Cross Wheelchair Loans
Crewe: 01270 214957 Answer phone bookings.
Open Monday 7.00am - 7.00pm
Congleton: 01260 295725 Open Monday,Tuesday,Thursday,
Friday 9.30am - 3.00pm. Closed Wednesday.
Haslington: 01270 581221 Answer phone bookings.
Open Wednesday 7.00am - 8.00pm
Knutsford Open
01565 682327
Monday
Tuesday
Wednesday
Thursday
2.00am - 4.00pm
9.30am - 11.30pm
9.30am - 12.00pm Midday
9.30am - 12.00pm Midday
Macclesfield: 01625 501759 Monday- Friday Office hours
Northwich: Open Wednesday 9.30am - 12.00pm Midday
01606 79162
Friday
1.00pm - 3.00pm
• National Osteoporosis Society
Tel: 01761 471771 · email: [email protected] · Website: www.nos.org.uk
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This leaflet is available in audio, Braille, large print and other
languages. To request a copy, please ask a member of staff.
This leaflet has been reviewed by the Readers’ Panel.
Fracture and Orthopaedic Department
Leighton Hospital
Middlewich Road
Crewe, Cheshire
CW1 4QJ
www.mcht.nhs.uk
Plaster Room
Tel: 01270 612242
Monday-Friday 9.00am-5.00pm
Appointments
Tel: 01270 612155
General Enquiries
Tel: 01270 612244
IMPRESSIONS DESIGN & PRINT 01270 767661
Printed on paper sourced from sustainable forests.
Revised and reprinted January 2015 Review January 2017 Ref: SC/ORTHOS/0030115