• Reference Number: HEY507/2025
• Departments: Orthopaedics
• Last Updated: 31 May 2025

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

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 tel: 01482 674378

Children’s Fracture Clinic tel: 01482 675731 / tel: 01482 675181

Emergency Department tel: 01482 482192

Plastics Clinic tel: 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.

General Advice and Consent

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 team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.