Frank Radcliffe Clinic
Plasters and Casts
Information
Please Read Carefully
Raise the injured leg or arm as much as possible, especially
during the first few days. This will help to reduce swelling.
Report to the Frank Radcliffe Clinic or Accident & Emergency
Department immediately if you have any of the following:
Continued swelling to fingers or toes after 24 hours
A lot of pain in the limb(s), fingers or toes
Blueness in the fingers or toes - not bruising
Pins and needles or coldness in fingers or toes
Pain, swelling or a hot feeling in the back of the calf muscle (if
it is your leg that is affected)
Unable to move fingers or toes
Any blister-like rubbing or pain under your cast.
Any discharge, wetness or smell under your cast
Do Not
Get your plaster wet - it will disintegrate.
Remove any wool/cast padding.
Push anything down inside the cast.
Walk on your leg plaster cast until you have been advised to
do so.
Sit close to a fire.
Allow the limb to hang down unless it is being used.
Cut, heat or otherwise interfere with your cast.
Drive with your cast (please discuss this with your
insurance company as it may invalidate your insurance)
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If your cast becomes cracked, loose, soft, tight or if you have any
concerns, please telephone one of the contact numbers
immediately.
Before coming to the clinic
It is recommended that any prescribed analgesia (pain killers) are
taken about an hour before your clinic appointment time.
Removal of your plaster
Your plaster will be removed using an electric saw with a special
blade.
The blade is designed so that if it touches the skin it should cause
no damage. However, on rare occasions, grazing to the skin may
occur. You should be aware of this small risk. Please feel free to
ask the staff if you have any queries.
Exercises when your arm is in plaster
1. Stretch your fingers and thumb out and spread them apart
gently.
2. Make a full fist, getting the fingertips into the palm, and curl
the thumb over the fingers.
3. Touch the thumb with the index finger then spread them apart.
Repeat with each fingertip. Do 10 of these exercises every 30
minutes. It is important to do these frequently to avoid swelling
and stiffness of the hand.
4. Touch the palm of your hand to the same-side shoulder then
straighten your arm fully.
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5. Lift your arm above head then lower.
6. Fold your arms across chest then spread them wide.
Do exercises 4, 5 and 6 ten times each, 3 times a day. Do not
discard the sling until advised to do so.
Exercises when your leg is in plaster
Lying on the bed or sitting on the floor:
1. Bend and stretch the toes up and down.
2. Push the back of the knee down into the plaster. You should
feel the muscles on the front of your leg tightening
3. Raise the leg 6 inches off the bed/floor, hold for 3 seconds,
then lower slowly
4. Raise the leg 6 inches, move it out to the side a short
distance, then return and lower slowly
5. Squeeze the buttocks together
Do not forget
when sitting:
•
raise your leg up on pillows or cushions to prevent swelling of
the toes
•
take the weight off your bottom frequently
Take a short walk, e.g. around the house, every hour.
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Crutches
To walk with crutches whilst your leg is in plaster: place both
crutches either side of your hip and bend your knee slightly
behind you. Move the crutches forward slightly then with your
good leg, hop forward slowly into your crutches.
Do
Take care when going up and down the stairs on your crutches (it
may be better to go up and down on your bottom).
If you feel you would have difficulty going up or downstairs in your
cast, please make clinical staff aware of this.
Do not
Rush around on your crutches
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Using crutches
Standing
Place the crutches in the 'H' position with the
handles together.
Place one hand onto both handles and stand up.
Once standing, place each hand through the
cuffs of the crutches and hold the handles
(handles facing forwards).
For stability while standing, each crutch
should be slightly in front of and out to the
side of your feet.
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Sitting
Stand in front of the chair. Take each arm out of the crutches
and put them in the 'H' position, holding with one hand. Once
balanced, reach back for the arm of the chair with the other hand.
In a slow and controlled manner, lower yourself into a sitting
position.
Walking
For non-weight bearing - Keep the injured leg off the ground
and, taking the weight with the other leg, place the crutches one
step ahead, level with each other. Move forwards between the
crutches, swinging the unaffected leg to land just in front of the
crutches.
For partial weight bearing - Taking some weight with the
unaffected leg, place the crutches one step ahead, level with
each other.
Put the injured leg on the ground, just before the crutches and
step through with the unaffected leg. Follow the instructions
given by your clinician regarding partial weight bearing.
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Care and maintenance of your crutches
Check regularly that:
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Rubber tips are not worn to the point where no tread is
showing
Crutches are a matching pair - do not use a mismatched pair
Crutches are tight at the elbow and are not cracked
Spring clip tips are located in both holes
Tubing is not cracked or damaged
Adjustment mechanism adjusts freely
The holes on the adjustment legs are round and not worn to
an oval shape
For trough I gutter crutches:
•
Check that the handgrip angle adjustment is tight and the
trough attachment bolts are tight
Always use the crutches as advised.
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Once set up for you, there should be no reason to adjust
the crutches without checking.
Always use the crutches as advised.
Avoid wet floors and uneven surfaces.
Remove obstacles, such as loose rugs, before using
crutches.
Do not store in sub-zero temperatures.
To use the crutches, wear supportive footwear.
Clean metal crutches with mild detergent and warm water.
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•
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Adequate lighting in the home environment is encouraged
for safety purposes.
Inspect the crutches regularly for signs of wear. If any of
the above is a problem contact the department.
Ankle fracture
What to expect when your cast is removed
You may find that after your cast is removed the ankle swells and
is more uncomfortable than it has been recently. This is normal
and is a consequence of removing the support provided by the
plaster.
To control swelling you should:•
•
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Avoid standing still for any length of time.
Sit with your foot up elevated on a chair when you are sitting.
Elevation is important to reduce swelling.
Use an ice pack wrapped in a damp towel and put it around
your ankle for 20 minutes with your foot up.
Try to start walking normally again, even if you are still using
crutches - with your injured foot allow gentle mobilisation as pain
allows. To walk initially put your heel down first and roll over the
toes of your injured foot and push off with your big toe (in a
rocking movement).
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Below knee walking boots or surgical braces that
prevent lower limb movement
Please ensure that you follow all instructions including
rehabilitation and any activity regime your prescribing
clinician has given you. This includes sitting with your foot
elevated, removing the boot from time to time and exercising your
foot and ankle, rotating your ankles through a 360 degree turn
clockwise and then anticlockwise direction 4 times a day.
This is important to reduce the risk of Deep Vein Thrombosis.
Signs and symptoms of a deep vein thrombosis or a
pulmonary embolism
While you are in hospital there are certain signs to look out for
that could mean you have a blood clot. You should seek medical
advice immediately if you experience any of the following in the
days or weeks you are in hospital and after your discharge home:
•
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You have pain or swelling in your leg.
The skin on your leg is hot or discoloured (red, purple or blue),
other than bruising around the operation site.
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Your feet are numb or tingling.
The veins near the surface of your legs appear larger than
normal or you notice them more.
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You become short of breath.
You feel pain in your chest, back or ribs, which gets worse
when you breathe in deeply.
You cough up blood.
•
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If you develop any signs of Deep Vein Thrombosis or think you
could have the signs of Deep Vein Thrombosis - please return
immediately to the Frank Radcliffe Clinic or your nearest A & E
department.
Contact Information
Frank Radcliffe Clinic
Monday to Friday 9.00am – 4.30pm
 01536 492445 Reception or 01536 492794 Sister's office
A & E Department  01536492350 (out of hours only)
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References
Prior, M.A. & Miles, S. 1999, Casting part two. Emergency Nurse,
vol.7, no. 3, pp. 32-39.
Prior, M.A. & Miles, S. 1999, Principles of casting. Journal of
Orthopaedic Nursing, vol.3, pp. 162-170.
If you need this information in another format or language,
please telephone 01536 492510.
Further information about the Trust is available on the
following websites:
KGH - www.kgh.nhs.uk | NHS Choices - www.nhs.uk
Ref: PI 102 April 2013
Review: January 2015