• Reference Number: HEY506/2025
• Departments: Orthopaedics
• Last Updated: 31 August 2025

Introduction

This leaflet has been produced to give you general information about your treatment. Most of your questions should be answered by this leaflet. It is not intended to replace the discussion between you and your doctor but may act as a starting point for discussion. If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team caring for you.

Cast Care Information

1. A Plaster of Paris cast takes 48 hours to dry.
2. A synthetic cast takes one hour to dry.
3. Casts must be kept dry at all times.
4. Elevation is important to reduce swelling.
5. Leg casts must not be walked on unless told to do so. (If you/the patient are able to walk with this cast, please ensure you/the patient wear the shoe provided).
6. Movement of joints and digits (toes, knees and hips) for 5 minutes in every waking hour is extremely important. Please read specific cast care advice sheet enclosed with patient documentation).
7. Do not poke anything down the cast as this may cause a sore.
8. Do not add extra padding as this makes the cast tight.

Complications that may occur whilst in a cast

If any of the following occur contact the Fracture Clinic medical staff. In an emergency when the clinic is closed, contact the Accident and Emergency department.

1. Increased pain that is not helped by pain relief and rest. Any pain in the calf.
2. Swelling, numbness, blueness, paleness or discolouration which is not bruising.
3. Pins and needles.
4. You/the patient is unable to move your/their toes/knee if not in cast.
5. You/the patient feel a burning sensation under the cast as this could be a blister or sore.
6. Any discharge or smells which come through the cast.
7. An object gets dropped down the cast.
8. The cast becomes loose or tight.

TREATMENT TO REDUCE THE RISK OF THROMBOSIS (BLOOD CLOTS) OF THE LOWER LEG

To reduce the risk of thrombosis (blood clots) in the deep veins, mostly in the lower leg or in the lungs (pulmonary embolism), you will have been given the option of two treatments for blood thinning to reduce the risk of a blood clot developing.

ORTHOPAEDIC/FRACTURE CLINIC STAFF TO COMPLETE

Subcutaneous Injection – Enoxaparin                                    YES/NO

Capsule – Apixaban                                                                YES/NO

If you do develop cramps, calf pain or swelling, breathlessness or chest pain, please contact the hospital urgently.

Checklist for patients with a lower limb cast

1. Leg to be elevated on pillows higher than the height of your/the patient’s heart (2 or 3 pillows required). Pillows to be placed under thigh and calf (not under heel), to prevent pressure on the heel. Heels should not be rested directly onto the bed.
2. When you/ the patient is seated in a wheelchair/chair, the leg should still be elevated on a stool with a pillow placed under the calf to protect the heel from pressure.
3. Please check the top and bottom of the cast daily for any redness, undue swelling, blistering or broken skin. Report to the Fracture Clinic immediately if any smells or staining come through the cast, or the Emergency Department if the Fracture Clinic is closed.

Removable casts with Velcro straps

ORTHOPAEDIC/FRACTURE CLINIC STAFF TO COMPLETE

Can the cast be removed daily for hygiene and skin check?                   YES/NO

Can the cast be removed for exercises?                                                 YES/ NO

Can the cast be removed to have a bath or shower?                              YES /NO

Was the skin intact prior to cast application?                                           YES /NO

Is there a sore, wound or suture present?                                               YES /NO

If the answer to the previous question is YES

Is a district nurse required?                                                                      YES/ NO

Has this been arranged?                                                                          YES/ NO

Has the home been contacted and verbal information given about the patient’s treatment and care?                                                   YES/NO/NOT APPLICABLE

Contact the fracture clinic for advice

Should you require further advice

on the issues contained in this leaflet, please do not hesitate to contact the Fracture Clinic or the Emergency Department

Fracture Clinic: Tel: 01482 674378 / Tel: 01482 674380

Emergency Department: Tel: 01482 482192

IF IT IS AN ANSWERPHONE, PLEASE LEAVE A MESSAGE WE WILL GET BACK TO YOU.

The Fracture Clinic staff are available to visit patient on the ward or to give advice

General Advice

Most of your questions should have been answered by this leaflet but remember that this is only a starting point for discussion with the healthcare staff looking after your patients.

CHECKLIST FOR STAFF TO COMPLETE AS APPROPRIATE