Care of a Cast, Splint or Surgical Boot

Introduction

This leaflet is designed to inform you about the care of your cast, splint or surgical boot. It also describes possible complications of having a cast, splint or surgical boot fitted.

Why are casts, splints or surgical boots used?

Cast, splints or surgical boots are used to control pain and allow the bones and or soft tissues to heal. Casts provide almost total immobilisation, often where there has been a bone break or fracture. Splints and surgical boots are often used to limit, but provide some controlled movement to help the tissues to heal.

How to take care of yourself and the cast/splint/boot?

Upper Limb Casts and Splints

You should:

• Remove jewellery /rings on affected arm as soon as possible.
• Exercise the joints not held in your cast or splint as much as possible e.g. fingers and elbows, if able.
• Elevate the affected limb, positioning it so it is above the level of your heart, especially during the first few days. This will help to reduce swelling and pain.
• Allow the cast to dry naturally- if made of Plaster of Paris. Leave the cast uncovered for the first 48 hours after it is provided.
• Inform the clinician/plaster technician if you plan to fly anywhere whilst in a Plaster of Paris cast.
• Check with your clinician regarding working, driving, sporting activities while in a cast or splint.
• Discuss your injury with your insurance company to confirm insurance liability/validity, as you must be able to control your vehicle safely.
• Protect your cast when washing/showering/bathing- you can purchase specially designed waterproof covers to keep you cast/splint/boot dry when bathing/showering. Please speak to the plaster technician and they will give you the information or visit link at the end of this leaflet.

Lower limb casts, splints or surgical boots

You should:

• Exercise the joints not held in your cast/splint/boot as much as possible e.g. ankle and toes, if able.
• Elevate the affected limb, positioning it so it is above the level of your heart, especially during the first few days. This will help to reduce swelling and pain.
• Allow the cast to dry naturally - if made of Plaster of Paris. Leave the cast uncovered for the first 48 hours after it is provided.
• Do not walk on the cast/splint/boot until you are instructed to do so.
• Inform the clinician/plaster technician if you plan to fly anywhere whilst in a Plaster of Paris cast.
• Check with your clinician regarding working, driving, sporting activities while in a cast/splint/boot.
• Discuss your injury with your insurance company to confirm insurance liability/validity, as you must be able to control your vehicle safely.
• Protect your cast when washing/showering/bathing- you can purchase specially designed waterproof covers to keep you cast/splint/boot dry when bathing/showering. Please speak to the plaster technician and they will give you the information visit link at the end of this leaflet.
• Continue with crutches/sticks until the clinician has advised you otherwise.

Actions to avoid

Please do not:

• Let your affected arm or leg hang down unless it is being used.
• Sit too close to a fire.
• Get the cast/splint or boot wet.
• Put talc or anything else down your cast/splint/boot to improve the smell.
• Cut, heat or otherwise interfere with the cast/splint/boot.
• Put any objects down your cast/splint/boot e.g.: knitting needle, coat hanger, pencil etc.
• Avoid sand, dirt or going into water.
• Knock or hit cast/splint/boot.
• If a lower limb cast, splint or boot, rest the leg on the heel for long periods. It is better to place a pillow under the affected leg.

Pain relief and comfort

Take regular simple pain medication as prescribed/advised by your clinician/GP/pharmacist to help with pain relief, if required. These medicines can be purchased over the counter or obtained from a high street pharmacy using the Minor Ailments Service.

Problems or complications to be aware of:

Complications of using a cast/splint or surgical boot are rare, however, there are some possible complications that you should be aware of and action immediately should they occur. These include:

• your fingers/toes become blue, white very swollen, or you are unable to move your arm/leg or fingers/toes.
• your arm/leg becomes more painful.
• you develop constant pins and needles or numbness in the arm/leg or fingers/toes.
• you feel a blister like pain or rubbing under the cast/splint/boot.
• if you experience a raised temperature, any localised heat/burning sensation in a specific area.
• there is a foul smell, some discharge, wetness under the cast/splint/boot.
• you drop any object down inside your cast.
• your plaster becomes wet from any fluid.
• you have swelling of your arm/leg above the top of the cast/splint/boot.
• the cast/splint/boot becomes cracked, soft or loose.

For patients with lower limb leg casts/splints/surgical boots

Following application of a leg cast/splint/surgical boot there is a small risk of developing a blood clot in the leg (a deep vein thrombosis – DVT).

Important - this risk can be reduced by keeping yourself mobile and avoid sitting for prolonged periods.

Signs and symptoms of a deep vein thrombosis (DVT) include:

• increased or renewed pain or swelling in the leg.
• pain in the calf or thigh, rather than over the fracture/injury site.
• shortness of breath.
• a sharp pain in the chest which is worse when you breathe in.
• coughing up blood.

If you experience any of the above signs or symptoms, you must seek urgent medical help. Either attend the Emergency Department (A&E) or dial 999.

For urgent advice only

Please contact the National Treatment Centre (NTC) - Fife Orthopaedics Plaster Room, Victoria Hospital, Kirkcaldy: 01592 643355 Extension: 29794 (Open Monday to Friday 8.30am to 5.00pm) for any urgent issues regarding casts, splints or surgical boots that have been supplied by the Paster Room or Orthopaedic Service, or if Out of Hours Services contact NHS 24/Minor Injuries or Emergency Department

For any urgent medical issues please contact Emergency Department Victoria Hospital Kirkcaldy: Telephone 01592 643355 Extension: 29001/2 (Open 24 Hours).

For Non Urgent Advice

For any Plaster/Splint issues, please contact one of the services below:

• National Treatment Centre (NTC) - Fife Orthopaedics Plaster Room, Victoria Hospital, Kirkcaldy: 01592 643355 Extension:29794 (Open Monday to Friday 8.30am to 5.00pm).
• National Treatment Centre (NTC) - Fife Orthopaedics - Virtual Fracture Helpline Answer Machine Service: 01592 643355 Extension:20140 (this is checked by a nurse once daily between the hours of 8.30am to 5.00pm Monday to Friday only).
• NHS 24 -Telephone 111.
• Minor Injuries Unit, St Andrews Community Hospital, St Andrews: 01334 465683 (Open Monday to Friday 8.00am to 6.00pm).
• Minor Injuries Unit, Adamson Hospital, Cupar: 01334 651200 (Open Monday to Friday 8.00am to 6.00pm).

Useful Sources of Information

General Advice: www.nhsinform.scot

NHS Fife Contact Numbers: www.nhsfife.org

Virtual Hand Clinic: www.fifevirtualhandclinic.co.uk

Protective Cast Sleeves: www.limboproducts.co.uk