Soft cast advice

Introduction

This leaflet will provide the information required to care for your soft cast and injury.

What is a Soft Cast?

Soft (semi-rigid) casts are made of a fibreglass casting material that does not set to a completely rigid state but remains flexible and soft even when completely set. They offer support in the treatment of soft tissue injuries, minor injuries in adults and some fractures in children. Soft casts are touch dry in three to four minutes and reach full strength in 30 minutes. Please take care of your cast during this time and leave it uncovered to allow the cast to dry naturally during this period.

What are the benefits?

Soft casts eliminate the anxiety of removing the cast with a cast saw, as the cast can be removed by simply unwinding or using normal scissors. This can be done at home after a specified period advised by your clinician, avoiding the need for a clinic visit. 

What can I do in the Soft Cast?

Depending on the type of injury, your cast may extend from your armpit or elbow to your fingers or from your hip or knee to your toes, restricting movement at certain joints associated with your injury. The type of injury affects whether you will be able to bear weight on your limb. You will be informed of your weight-bearing status during your consultation.

After your cast has been applied, it is important to take care of your cast and regularly do the following:

• Move your fingers, toes, and other joints not immobilised by the cast several times every hour.
• Keep the limb elevated (above the heart level) when not in use, especially in the first 48 to 72 hours, to help reduce the swelling.
• If a sling has been provided, it should be worn up and about during the early stages after application to reduce swelling.
• Remember to remove the sling regularly and move the joints as advised.
• Wear the cast shoe provided if your clinician has advised you to walk on your plaster.
• Use walking aids as instructed.

It is important that you take care not to do any of the following:

• Get the cast wet, as this will cause various skin problems and a reduction of your cast’s strength.
• Push objects down the cast for any reason, such as to scratch, as wounds and ulcers can develop.
• Cut or adjust the cast yourself.
• Attempt to dry your cast with a hairdryer, as your cast will become hot and may burn you.
• Let the limb hang down unless it is being used, especially during the first few days (the limb needs to be elevated at heart level to reduce the swelling).
• Remove the cast yourself before being advised.
• Wear a watch, ring or jewellery on the injured limb.
• Walk on the cast until it is completely dry, and then only if you have been told to do so by your clinician.

What exercises should you do in the Soft Cast?

It is important to exercise all joints not immobilised in the cast and to repeat every couple of hours until fully functional. This helps reduce swelling and stiffness, maintain muscle strength, and improve circulation. This can be painful and difficult to start with, but it should improve within the first week. 

Upper Limb:

• Fully straighten your fingers and then bend to make a fist 5 times.
• Circle your thumb and then touch to each finger.
• Fully straighten and bend your elbow.
• Rotate the shoulder, lift your arm above your head, followed by placing your arm behind your back.

Lower Limb:

• Wiggle your toes regularly.
• Fully straighten and bend your knee (if the cast ends below your knee).
• Gently tighten the muscles in the back of your calf and thigh to improve blood flow.
• Move your hip joint.

Please contact us immediately should you experience any of the following symptoms

• Pins and needles, numbness, blueness which is not relieved by elevation.
• Excess pain or swelling.
• Soreness or rubbing under the cast.
• Discharge or bleeding through your cast.
• A strong smell under your cast.
• If you drop anything down your cast.

Deep Vein Thrombosis (DVT) signs and symptoms

Due to immobilisation and reduced mobility, there is a higher risk of developing a Deep Vein Thrombosis (DVT) in some people, especially with lower limb casts. It is important to stay as active as possible, drink plenty of fluids and be aware of the signs and symptoms. Please contact the Orthopaedic service or the Accident and Emergency department (see contact details at the end of this information) if you experience any of the following: 

• Pain in the calf, thigh or chest.
• Sudden onset of shortness of breath with no physical exertion.
• Swelling of the limbs.
• Increased and decreased warmth of the limbs.
• Redness in the limbs.
• Bluish skin discolouration in the limbs.

Pressure Sores (Ulcers)

A pressure sore (ulcer) is a type of injury that breaks down the skin and underlying tissue. A small number of high-risk patients (such as patients with existing skin problems or diabetes) are at increased risk of developing a pressure sore, especially in long leg casts, which reduce mobility. To try and avoid this:

• Make sure to regularly reposition your leg throughout the day so that you are not constantly resting on the same area for long periods (every 2 hours).
• If you notice any discomfort or pain under the cast, most noticeably at the cast edges or heel, please contact the Plaster Room for urgent review (National Treatment Centre - Fife Orthopaedics Plaster Room, Victoria Hospital, Kirkcaldy: 01592 643355 Extension: 29794 (Open Monday to Friday 8.30am to 5.00pm) or Contact the Orthopaedic Service details at the end of this information).
• Ensure the top or bottom of the cast is not rubbing and leaving red marks.
• Do not rest the leg on the heel of lower limb cast for long periods of time, and place a pillow under the leg.

When and how is the Soft Cast removed?

Once the time comes to remove your cast, you can remove the cast yourself at home after the specified number of weeks after the Soft Cast has been applied, as informed by your clinician.

No further treatment or follow-up should be required after the Soft Cast is removed.

To remove the Soft Cast, find the end of the cast bandage and unwind this, or cut it off with blunt-edged scissors as demonstrated in the following video below.

What should you do after the Soft Cast has been removed?

As your limb has been immobilised for some time, you may experience some of the following common symptoms on removal of the cast:

• You may experience swelling, discomfort and stiffness in the affected limb. This is quite normal and may continue for several weeks. You may find it helpful to keep the limb elevated.
• You may find that your limb feels thin and strange, this is normal owing to disuse muscle wasting.
• Your skin may be dry and itchy. Do not scratch, try using baby oil or moisturiser.
• Your skin will be sensitive. Be careful if going out in the sun and apply a sun block.

Returning to activities of daily living

There are no specific time frames for returning to your usual activities, varying from person to person. Symptoms may be ongoing for several months, and you may need to adjust your activities and pace yourself during your recovery. Aim to increase your levels of activity gradually, avoiding worsening of your symptoms. Progress your activities as your symptoms and movements improve.

Worries or concerns

For non-urgent issues or concerns:

For non-urgent issues or concerns, please contact your Consultant’s Secretary through the NHS Fife Hospital Switchboard at 01592 643355.

For urgent issues or concerns:

If you have any urgent concerns regarding your condition, please get in touch with the Orthopaedic service:

Urgent advice for patients between 8am to 7.30pm Monday to Sunday, contact the National Treatment Centre - Fife Orthopaedics on 01592 643355 Extension 22685.

Urgent out-of-hours advice:

For an urgent problem that is out of hours, please get in touch with NHS 24 on 111 or visit Accident and Emergency.

Emergency advice:

For emergency advice, visit Accident and Emergency or dial 999.