Cast & Splint Care

Cast vs splint — what you have

A cast is a hard, one-piece shell made of plaster or fiberglass that fully encircles the arm. It cannot be removed at home and is taken off in the office with a special saw. A splint (sometimes called a "half cast") is a partial cast held on with an elastic bandage, or a custom plastic splint from a hand therapist. Splints are usually removable for skin care and exercises.

Your provider will tell you whether yours is meant to stay on continuously, or whether you can take it off for bathing or for exercises. If you are not sure, call the office to check before removing it.

Keep it dry

• Plaster and fiberglass casts, and most splints, lose their shape if they get wet. A wet cast no longer supports the bone properly and can cause skin breakdown.
• For showering, cover the cast with a plastic bag sealed with tape at the top, or use a dedicated cast cover (available at most pharmacies and online). Keep the arm out of the direct spray as much as possible.
• If the cast becomes damp on the outside, let it air-dry. You can use a hair dryer on a cool setting — never hot.
• No swimming, baths, pools, or hot tubs while the cast is on.

Do not put anything inside the cast

• Itching is normal, particularly in the first few days. Do not slide coat hangers, pens, knitting needles, or other objects down the cast to scratch — the skin inside is fragile and easy to cut, and a small cut inside a cast can become infected.
• A hair dryer on a cool setting, blowing into the top of the cast, usually relieves itching quickly.
• Do not sprinkle baby powder, lotion, or oil inside the cast — they clump and can irritate the skin.

Elevation and swelling

• Keep the hand elevated above the level of your heart as much as possible, especially for the first 3 to 5 days. This is the single most effective way to reduce swelling, throbbing, and pain.
• Wiggle your fingers often — gentle, frequent finger motion pumps fluid out of the hand and prevents stiffness.

Signs that the cast is too tight

Swelling inside a cast can make it feel tighter over the first few days. Some tightness is normal. Call the office, or go to the emergency department if the office is closed, if you develop any of the following:

• Fingers that are pale, blue, or cold compared to the other hand
• Numbness or pins-and-needles in the fingers that does not go away when you wiggle them
• Increasing pain that is not controlled with elevation and pain medication
• Inability to move the fingers at all because of pain or pressure
• A burning or pressure spot inside the cast (especially over a bony prominence) that does not ease up

Skin care

• If your splint is removable, take it off once or twice a day and gently wash the skin with soap and water, then pat it dry before putting the splint back on.
• Watch the edges of the cast or splint for red marks on the skin. A mark that does not fade within 15 minutes of relieving pressure, or that blisters or breaks open, needs to be seen.
• Do not trim or break off pieces of the cast at home. If the edge is rough, tape a small piece of moleskin or soft tape over it, or call the office and we will "petal" the edge with tape.

If your cast or splint gets damaged

Call the office if the cast becomes soft, cracked, wet through, or if a piece breaks off. A cast that is no longer rigid is not doing its job of protecting the bone. We will bring you in to have it replaced.

Questions?

Call your office location for non-urgent questions:

• NYU Langone Laurelton · 646-501-4950
• NYU Orthopedic, Woodside · 929-429-3222
• NYU Orthopedic, Richmond Hill · 718-206-6923
• Jamaica Hospital Ambulatory Care Center (ACC) · 718-301-0720

See our office contact information for addresses and fax numbers.