Taking Care of Your Child’s Cast

Broken bones, or fractures, are a common childhood hazard, particularly for kids in sports.  While it can happen in a split second, a broken bone takes time to heal and may often require a cast.  The experts at the CHOC Children’s Orthopaedic Institute understand that kids with casts – and their parents – have lots of questions.  Dr. John Schlechter, CHOC orthopeadic surgeon, recently sat down to provide answers to some of the most frequently asked questions he and his colleagues receive.

Q: What material is a cast made of, and what does the cast do?
A: There are two types of cast – one made of hard plaster and the other a fiberglass shell.  Both work to prevent movement of the broken or fractured bone, and allow proper healing to occur.  The amount of time a cast has to remain on a child depends on the type of injury.

Q: Can my child take a bath or shower with her cast on?
A: Unless a child is wearing a special waterproof cast, she should not get her cast wet. This is best avoided by taking a sponge bath, while still covering the cast with several layers of a towel or plastic bags. In the event a cast gets wet, dry it with a hair dryer on the cool setting.

Q:  How do I can get my child a waterproof cast?
A: Not all fractures are suitable for a waterproof cast. If a child can have a waterproof cast, his parent must request it.  These special casts, which can be completely submerged in fresh water, are available at additional costs and not typically covered by insurance.

Q: Do I need to elevate my child’s arm?
A: Elevating the affected limb for the first 24 hours significantly reduces the natural swelling that occurs after an injury.  Place the injured limb above the level of the child’s heart (the “high five” position for arm injuries), using pillows as support.  Moving fingers or toes on the affected limb may also assist in swelling.

Q: What can be done to alleviate itching under the cast?
A:  Tapping on the cast or blowing cool air inside the cast with a hair dryer can help alleviate itching.  Under no circumstances should an object be placed under the cast to scratch.  This may cause injury or infection.  If the itching becomes severe or persistent, speak to the child’s physician.

Q: How do I know if my child’s cast is too tight or too loose?
A: The most common symptoms of a cast that is too tight are:
• Numbness, tingling
• Increased pain
• Change in skin color compared to the unaffected limb (pale or blue, by comparison)
• New swelling of the fingers or toes

Keep in mind that swelling is expected in the first 24-72 hours, which may make the cast feel tight.  Elevating the injured limb should help reduce the swelling.  Once the swelling subsides, the case may then feel loose.  As long as the child cannot move the limb under the cast or take the cast off, he is fine.

Q: Is it normal for my child’s cast to smell?
A: Unfortunately, cast odor is normal since the affected limb cannot be bathed.  Never apply powder or perfume on or inside the cast.

Q. Can my child resume normal activities?
A: Children should enjoy being kids, and there should be no restrictions to activities of daily living.  However, they should avoid activities that can damage the cast, including getting it wet, or re-injure the limb.  This may include swimming, bicycle riding, skate boarding, contact sports, etc.

Visit www.choc.org/orthopaedics to learn more about the CHOC Children’s Orthopaedic Institute.

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