Upper Limb Cast Care Information – For Patients and Carers of a Patient

Patient Leaflets Team

  • Reference Number: HEY-507/2021
  • Departments: Orthopaedics

Introduction

This leaflet has been produced to give general information for patients and carers of a patient with an upper limb cast.  Most of your questions should be answered by this leaflet.  It is not intended to replace the discussion between you and the healthcare team, 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.

Cast care information

Your cast has been applied to keep your injury from moving so that you feel less pain and to help the healing process.

  1. A Plaster of Paris cast takes 24 hours to dry.
  2. A synthetic cast takes 1 hour to dry.
  3. Casts must be kept dry at all times.
  4. Elevation is important to reduce swelling.
  5. Above elbow Plaster of Paris casts need a sling for 24 hours.
  6. Above elbow ‘backslabs’ needs a sling continuously.
  7. Movement of joints and digits (fingers, elbow and shoulder) not in cast for five minutes in every waking hour is extremely important unless you are advised otherwise.
  8. Do not poke anything down the cast as this may cause a sore, do not add extra padding as this makes the cast tight.
  9. Do not use a sunbed whilst wearing a cast.

If you drive a vehicle with a cast on you may be liable to prosecution under the Road Traffic Act 1988. Please check with your insurance company that they still provide cover.

Complications that may occur whilst in the cast

If any of the following occur, contact the Fracture Clinic medical staff. In an emergency and the Fracture Clinic is closed, contact the Emergency Department (see contact details at the end of this leaflet).
  1. Increased pain that is not helped by pain relief and rest.
  2. Swelling, numbness, blueness, paleness or discolouration which is not bruising.
  3. Pins and needles.
  4. You or the patient is unable to move their fingers, elbow, shoulder.
  5. You or the patient feel a burning sensation under the cast as this could be a blister or a 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.

Care when in an Upper Limb Cast

  1. For below elbow casts elevate your or the patient’s hand at heart height or rest on opposite shoulder. Do not keep in a sling unless advised to do so.
  2. Do not let your or the patient’s arm hang down below waist level when sat in a chair or walking.
  3. Please check the top and the 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.

Removal of Casts

If the doctor has said you may remove your cast for bathing, you may need someone to help you to do this.  If the doctor has said that the cast is to be removed for physiotherapy or wound checks, then it should not be removed at any other time as this may affect your injury.

To remove a cast with Velcro straps or bandage, undo the strap or the bandage. Spread open the flexible section of the cast using your hand, you may need help to do this, and carefully lift the limb free of the cast.  To reapply your cast, reverse this procedure: please be very careful to make sure that your arm returns to the position it was in before you removed the cast.  Make sure the straps or bandages are firmly fastened but are not too tight.

DO NOT stop wearing your cast until your doctor has said it is safe to do so.

Orthopaedic/fracture clinic staff to complete

Can the cast be removed for a hygiene and skin check daily? YES / NO / NOT APPLICABLE
Can the cast be removed for exercises? YES / NO / NOT APPLICABLE
Can the cast be removed to have a bath or shower? YES / NO / NOT APPLICABLE
Is there a sore or wound or sutures present? YES / NO / NOT APPLICABLE
If the answer to the previous question is YES is a district nurse required YES / NO / NOT APPLICABLE
Has this been arranged? YES / NO / NOT APPLICABLE
Has the patient or carer been advised regarding treatment and care? YES / NO / NOT APPLICABLE

If you develop complications or require further advice on the issues contained in this leaflet, please do not hesitate to contact the Fracture Clinic, Plastics Clinic, or the Emergency department on the following numbers.

Fracture Clinic (01482) 674378
Children’s Fracture Clinic (01482) 675731 / 675181
Emergency Department (01482) 482192
Plastics Clinic (01482) 674509

If it in a non-emergency and you reach an answerphone, please leave a message and we will get back to you.

The Fracture Clinic staff are available to visit inpatients on a hospital ward to give advice.

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