What types of casts are there & why are they used?

A cast provides protection (it acts like a hard shell), and immobilization (it keeps the injured body part still while it heals), and consists of two distinct layers. A soft cotton layer that rests against the skin with an outer layer comprised of either fiberglass or plaster. These days we typically use fiberglass because it is cleaner and lighter and comes in all sorts of colors.

How is a cast put on?

First, a stockinette (light stocking material) is applied over the injured body part. Next, several layers of soft cotton are wrapped around the injured area to protect against the pressure the cast can cause. Finally, fiberglass is soaked in water (this activates the fiberglass so it hardens), and then wrapped around the cotton until completely covered. The outer layer will dry to a hard, protective covering.

What Colors can I get?

We have all the colors of the rainbow. There a plenty of color samples for you to look at so you can figure out which one is best for you. Having a broken bone is no fun, so have some fun with the color!

Is it OK to have people sign and draw on my child’s cast?

Definitely! That often makes the whole broken bone experience more tolerable for kids. Permanent markers usually work best; washable ones can smear. Feel free to encourage siblings, family members, and classmates to sign it, draw pictures on it, or decorate it with stickers. When the cast is finally off you can choose to keep it if you wish.

Can fiberglass casts get wet?

Although the fiberglass itself is waterproof, the padding inside a fiberglass cast is not. So it’s still important to try to keep a fiberglass cast from getting wet. If this is a problem, talk to the doctor about getting waterproof cast padding. Fiberglass casts with waterproof padding let kids continue bathing or even go swimming during the healing process. Although this special padding allows for evaporation of water and sweat, it’s still fragile. Unfortunately only certain types of fractures can be treated with this type of cast which your physician will discuss with you.

What if my child has an itch in the cast?

You could try blowing some cool air in the cast with a hair dryer. You should never pour baby powder or oils in the cast to try to relieve itching or try to reach the itch with long, pointed object such as a pencil or hanger — these could scratch or irritate your child’s skin and could lead to an infection.

What if the cast gets a cracked or damaged?

Although unlikely this could happen if the cast is hit or crushed. Call your doctor if this occurs so the cast can be repaired or changed. If indeed an injury has occurred to cause the cast to crack x-rays will need to be repeated to insure further damage has not occured.

What if the cast is too tight?

When the cast is too tight patients may see discoloration in the skin around the cast such as the fingers or toes. If the skin becomes pale, or bluish, or if the patient begins to lose feeling in the toes or fingers the cast needs to be loosened immediately. Contact your doctor immediately, or go to the emergency room so the cast may be cut to allow for swelling. Most of the time once the cast is cut the pressure is relieved immediately, however sometimes the cast has to be changed or converted to a splint for a short time to allow for swelling which will eventually come down.

Do all broken bones need casts?

No. In fact many fractures are unable to be casted based on the location such as the clavicle (collar bone). Other fractures may be stable enough to only require splinting. Casting depends on what body part is effected and what type of fracture you have. If indeed a cast is not necessary your physician will discuss appropriate options with you. Regardless the safety of our patients is the most important thing to consider.

Will my child feel pain when the broken bone is in a cast?

Typically fracture pain reduces significantly after the first two or three days, but your physician may prescribe pain medication in the event of more significant pain.

How are casts taken off?

The doctor will use a small electrical saw to remove the cast. Although it may look and sound a little loud the process is actually quick and painless. The saw actually vibrates up and down it does not spin, and since the skin can move with the blade it will not cut the skin, but breaks through fiberglass easily. Because the saw vibrates so quickly it sometimes gets hot. If you feel things getting too warm just tell the technician and they will let the blade cool which takes only a few seconds. The whole process takes only minutes and then you can have your cast if you wish.

What will the injured area look and feel like when the cast is removed?

Once the cast is off, the injured area will probably look and feel pretty weird. The skin will typically be pale, dry, or flaky; hair will look darker; and the area (muscles especially) will look smaller or weaker ( what we call atrophy). Don’t worry, though — this is all temporary. Depending on the age of the patient most strength issues will resolve over the course of several weeks. Sometimes physical therapy is utilized to help with stiff joints after a cast is removed. Typically the younger the patient the fewer complications seen, and the less likely therapy would be needed.