All about casts

Did your child's summer activities leave behind a broken bone and a bright colored cast? The cast specialists from the Tulane Lakeside Orthopaedic Clinic weigh in the best ways to care for a cast so broken bones can heal quickly and effectively. Here are answers to some common questions about casts:

What is the purpose of a cast?

A cast heals a bone by keeping it from moving. It has two layers: a soft cotton layer rests on top of the skin and a hard outer layer covers the cotton to prevent the broken bone from moving. Not all broken bones need casts, however. Some fractures, such as fractures to the rib or collarbone, do not require a cast and are instead healed with a sling or strap. Other broken bones can be set with a splint or taping method.

Are there different types of casts?

There are two different kinds of casts. Plaster of Paris casts are made from a heavy white powder that forms a paste when mixed with water. It then hardens quickly to form a cast. Synthetic (fiberglass) casts are made out of a moldable plastic and come in many bright colors.

How is a cast put on?

Your casting specialist or doctor will wrap several layers of cotton around the injured area. Then the plaster or fiberglass outer layer is soaked in water and wrapped around the cotton. The outer layer will dry to make a hard, protective covering.

Can my cast get wet?

A Plaster of Paris cast cannot get wet! The plaster will begin to dissolve in the water, preventing it from holding the bone in place. It could also irritate the skin. Although a fiberglass cast is water-resistant, it should not be submerged in water. It is possible, however, to get a fiberglass cast with a waterproof liner. Ask your doctor about a waterproof cast, since only certain types of breaks can be treated with that option. If your cast is not waterproof, wearing a plastic bag or purchasing a special sleeve to protect your cast from water is the way to go.

How do I scratch under my cast?

Try using a hair dryer to blow some cool air into the cast to calm the itching. Never pour baby powder or oil into the cast and never stick long pointed objects into the cast, as they could cause irritation and infection.

When should I get my cast replaced?

If your cast gets a crack, call your doctor as soon as possible for a replacement or repair. If your fingers or toes begin changing color, call your doctor right away because the cast may be too tight. Redness and rawness are typically signs the cast is wet inside from either sweat or water or the padding has been stripped away. To prevent infection, call your doctor to have the problem fixed immediately.

How is a cast taken off?

Your doctor or cast specialist will use a small electrical saw with a dull, round blade to break apart the cast. The saw will not hurt your skin, but it may tickle. The area under the cast will be pale, dry and weaker than other parts of your body. This is all temporary and will change with time and physical therapy.

If you have more questions about casts or would like to schedule an appointment with a pediatric orthopedic specialist, call the Tulane Lakeside Orthopedic Clinic at (504) 988-8010.