+ Cast Care Instructions
Here is some basic information in regards to caring for your new cast.
The outside of your cast is fiberglass. The inside of your cast is usually either a soft cotton material or a waterproof material.
Problems To Watch For
These things can be signs of problems in the cast and should any occur, you should contact our office immediately.
- If the fingers or toes become discolored, numb, or painful with small movements or if you are unable to move your fingers or toes.
- If the fingers or toes swell to approximately twice the size of those of the unaffected limb even after rest, ice, elevation, and medication.
- If a foul odor or fluid is coming from the cast or splint.
- If you are experiencing a burning sensation or rubbing inside the cast.
- If the cast cracks or breaks.
- If the cast becomes too tight or loose. A loose cast may develop into more serious problems, such as pressure ulcers, skin abrasions, or infections.
- If the cast edges are irritating the skin.
- If you experience an increase in pain even after rest, ice, elevation, and medication.
- If you develop a fever.
DO NOT attempt to remove your cast. You could do further damage to your injury or sustain a new injury simply trying to remove the cast.
DO NOT put anything in your cast. Sticking something (coat hanger, ruler, etc...) in the cast can scratch the skin, which could lead to an infection. Furthermore, anything you stick in the cast could get stuck, which could also cause skin irritation or an infection. Please contact our office if something gets stuck in your cast.
- Keeping your cast dry is very important. There are no devices that are 100% effective in keeping any cast dry. Sponge baths are the safest way to keep the cast dry. If you have to take a bath or shower, please follow these instructions.Place a towel or washcloth around the upper portion of the cast.
- Cover the entire cast with a plastic bag.
- Secure the bag at the top with tape or a rubber band.
- If the cast gets moist at the top or bottom, use a blow dryer set to the cool setting to dry the cast.
- If the cast is soaked all the way through, it needs to be changed and you should contact our office.
- Please not that these methods will not protect a cast in the pool or when submerged in water and that most insurance companies do not pay for unscheduled cast changes secondary to wet casts.
- If you were given a waterproof cast, the cast is completely waterproof. You are allowed to submerge the cast in any amount of water. You are free to bathe, shower, and even swim, if it has been approved by your doctor.
- To make sure your waterproof cast stays clean, please run warm soapy water through the cast as needed.
- We generally do not put waterproof casts around ankles and elbows because skin irritation and pressure sores may develop in those areas. We also do not use waterproof casts immediately after surgery because of the possibility of infection.
How to manage swelling within the first couple of days of injury:
Swelling is greatest in the first 24-48 hours after the injury. To help minimize swelling in your cast follow these simple instructions.
Elevate/raise the cast above the level of the heart.
- Arm Casts: It's important to raise your hand above the elbow, which should be above your heart. If you just raise the elbow portion on pillows the hand is likely to swell. A simple method is to lie down on your back with the arm out to your side and the fingers pointed up towards the ceiling.
- Leg Casts: Lie down on your back with the leg propped up on approximately two pillows. Again, the pillows should be under the calf and heel area, not just under the knee.
Wiggle your fingers or toes as tolerated.
Use your sling intermittently during the first 24-48 hours after injury. Your arm and hand will be below the level of the heart while in the sling and that can increase the initial swelling.
Non-steroidal anti-inflammatory medications such as Motrin or Advil can be taken. Take as directed on the bottle. DISCONTINUE IF THIS CAUSES AN UPSET STOMACH.
Newest research suggests these medications may negatively interfere with fracture healing. Prolonged use for more than 48 hours in the first 3 weeks after a fracture is not recommended.
If these methods fail, your cast may need to be split down the sides to allow for swelling to resolve. Please contact our office and DO NOT attempt to alter or remove the cast yourself.
+ Pre-Operative Instructions
Stop taking anti-inflammatory medications and anticoagulants (these include Coumadin, Vitamin E, Fish Oil, Aspirin, and any Ibuprofen or Naproxen products) prior to surgery. Your doctor will notify you how long to stop taking these medications prior to your surgery. You may take Tylenol as needed for pain. If you take a daily prescribed blood thinner, you are to consult with the prescribing doctor on dosage instructions for before and after your surgery.
No eating or drinking for 8 hours prior to surgery except for prescribed medications.
Take prescribed medications on the day of your surgery with a small sip of water.
We recommend being aware of your surroundings and avoid staying outside for a long period of time to avoid scrapes, rashes, blisters, abrasions, or bug bites. We do not want any open wounds or rashes on the affected extremity. If you notice any type of these skin conditions, please contact our office so we can perform a quick skin check.
Do not shave the affected extremity for 1 week prior to your surgery and remove any artificial nails and/or nail polish.
If you have a fracture requiring surgery, please keep the affected extremity elevated as much as possible to keep the swelling to a minimum.
+ Post-Operative Instructions
Keep the incision clean and dry.
Keep cast or splint clean and dry, and do not try to remove it. If there are problems with the cast or splint, please contact our office or on-call doctor.
Maintain a schedule of prescribed pain medications. Once a severe level of pain is reached, it is much more difficult to control the pain.
Keep your extremity elevated (if possible) to minimize swelling. This will also help with pain control.
It is not unusual to have a slight fever after general anesthesia for the first 24 to 48 hours after surgery. Drinking fluids, deep breathing, and coughing are helpful after general surgery to limit the development of fever. Any high fevers over 101.5 may be more concerning. Please contact the office for further instructions.
Pain medicine can cause itching, nausea, and/or constipation. These are all COMMON side-effects of narcotic-based medicine and are not necessarily a drug allergy.
If you have a pain pump, please call the office to have the pain pump removed in 24 to 48 hours.
It is not unusual to have swelling and pain of the extremities after surgery. If necessary, the ace wrap can be loosened if it seems too tight, but please do not remove the splint (if applicable).
It is not unusual to have some mild bleeding that soaks through the dressing. Please reinforce the dressing with more gauze dressing, or ace wrap, if available, to provide more compression. If this does not control the bleeding, then please contact the office.
Please contact the office with any further questions.
+ Post Total Joint Replacement Instructions
Perform gait training as taught by physical therapists.
No hip strengthening exercises for 6 weeks.
After 6 weeks post-op, be aware of these hip precautions:
- No sitting in low seats/chairs
- No squatting to pick up objects off the floor
- No crossing legs
- No driving unless otherwise instructed
If any invasive procedure such as dental work, colonoscopy, or other surgeries are planned, please contact the office for antibiotics to be taken prior to a procedure. This will lessen the risk of post-operative joint infections.
+ Post Lumbar Fusion Instructions
Ambulate as instructed by physical therapists with a brace on at all times.
It is not unusual to experience wound drainage immediately post-op. If this persists for more than 5 days, or if the drainage is foul smelling or cloudy, please contact the office for further instructions.
Any sudden change in neurovascular statuses such as sudden, new weakness or numbness in the legs, loss of control of bowel or bladder function is concerning. Please notify our office or on-call doctor immediately.
Persistent headaches or lightheadedness after surgery may be of concern. Please call our office for further instructions.