Plaster Cast Care (Child)

A cast keeps a broken bone in place so it can heal. Plaster casts are heavier than fiberglass casts. But plaster casts shape better. This gives better support for certain fractures such as broken bones in a hand.

Casts are custom made. A cotton or synthetic lining is gently put around the fracture. This protects the skin. Moistened plaster tape is put in layers on top of the lining. The rough edges of the cast are covered with the lining or cotton gauze. Plaster casts may take several days to dry, depending on the size of the cast. You must take care to help the cast dry and to prevent dents. Children can go back to some of their normal activities once the cast is dry.

Home care

Follow these guidelines when caring for your child at home:

• Your child’s healthcare provider may prescribe medicines to ease pain and itching. Follow the provider’s instructions when giving these medicines to your child.
• Make sure the cast dries. Keep it uncovered for a few days. For larger body casts, you may need to turn your child every few hours. On humid days, you can use a hair dryer set on cool to help dry the cast. Limit how active your child is until the cast dries.
• Handle a wet cast carefully. To prevent dents, hold the cast with the palms of your hands instead of your fingers.
• Have your child sit or lie down and raise the injured area above heart level as often as possible for the first few days. This will help reduce swelling. Use a sheet of plastic to protect pillows from a wet cast.
• Put ice bags or packs around the cast to reduce swelling or ease itching. You can make an ice pack by wrapping a plastic bag of ice cubes in a thin towel. As the ice melts, be careful that the cast doesn’t get wet.
• Look at the cast every day for any damage such as a soft or flat area, flaking, or cracking.
• Check the skin around the cast several times a day. The skin should look healthy and not be swollen. Your child should be able to move all fingers and toes.
• Have your child wiggle toes or fingers or tighten and loosen muscles several times a day. This will help increase blood flow.
• Pressure sores or ulcers can develop on bony prominences such as heels and elbows even if they are covered by a cast. Therefore, it is important to protect bony prominences from pressure. A leg cast should be supported under the child’s calf letting the heel hang free. A full arm cast should be supported under the forearm letting the elbow be free from pressure. Don’t let your child put objects inside the cast. Also don’t let the child stick anything inside the cast to scratch an itch.
• Lessen itching by distracting your child. It may help to scratch the opposite limb or scratch the skin outside of the cast.
• Keep the cast dry. When your child is near water, wrap the cast in plastic bags.
• Clean the outside of the cast, if necessary, with a damp cloth and toothpaste or a gentle cleanser. Pat the wet area with a dry towel, then gently blow-dry with a hair dryer set on cool.
• Avoid breaking off any edges of the cast. Only the healthcare provider should adjust or remove a cast.
• Look at the skin underneath the cast for the signs of infection listed below. Use a flashlight to help you see.
• If your child has a hip or large leg cast, talk with the provider about tips for how to use the toilet and how to prevent skin irritation.

Follow-up care

Follow up with your child’s healthcare provider, or as advised.

When to seek medical advice

Call your child's healthcare provider right away if your child has a fever (see Fever and children below)

Also call your child’s provider right away if any of these occur:

• Cast seems too tight or too loose
• Wet or soggy cast
• Pain gets worse or doesn’t get better when taking prescribed pain medicine
• Pale color or discoloration of skin around cast
• Numbness or tingling near or under the cast
• Signs of infection. These include redness, swelling, or pain that gets worse. These also include warmth or a foul-smelling fluid that drains from the cast.
• Surface of cast feels warm

© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions. This information has been modified by your health care provider with permission from the publisher.