Plaster for a fracture holds the broken bone in position and rests the limb while the bone heals. It is how many fractures of the arm, wrist, hand, leg, ankle and foot are treated. Instructions from the doctor who applied your cast take priority over this general advice.
What a plaster cast does, and when it is enough
A cast stops movement at the fracture so the bone can knit. It suits fractures that are not displaced, or that can be moved back into place by hand (reduction) and then held. Badly displaced bones, fractures that enter a joint, wounds over the fracture, or a position a cast cannot hold are usually better fixed with plates, screws or a nail. The choice follows examination and X-rays. Fracture and trauma care in Surat covers surgery.
How a plaster cast is applied
Dr. Aman Khanna's OPD at Mahavir Health Campus, Athwa Gate, applies plaster casts, and some simple realignments (reductions) are also done in the OPD. The usual steps are examination and X-ray, removal of rings, bangles and watches before swelling traps them, then soft padding and wet plaster bandages moulded to the limb, with an X-ray repeated if needed to confirm the position. Other fractures that need realignment are done in hospital under anaesthesia. If the limb is very swollen, a half cast (back slab) may be used first and a full cast applied once swelling settles. Plaster of Paris takes a day or two to harden fully, so avoid pressure on it meanwhile.
A clearly deformed limb, a wound over the fracture, heavy bleeding or loss of feeling needs the emergency department first.
Leg and ankle casts
For a leg or ankle cast, put no weight on it unless you are told. Many are non-weight-bearing at first, with crutches or a walker, and some are changed later to allow walking. A foot cast follows the same approach. Keep the toes visible so colour and movement can be checked, and keep the foot raised.
Hand, wrist and arm casts
For a hand, wrist or arm cast, the fingers are usually left free. Move them often, and rest the arm on pillows above heart level. A wrist that stays painful at the base of the thumb should be reviewed, since a scaphoid fracture can be missed on the first X-ray. Wrist fracture surgery explains when a wrist fracture needs fixing.
Plaster and fibreglass casts
Plaster of Paris is white and softens in water. Fibreglass casts are lighter and come in colours such as blue. The colour has no medical meaning, and neither type should be wetted unless you are told it is waterproof.
Caring for a cast at home
- Keep it dry. For washing, cover it with a thick plastic bag sealed above the cast, and keep it out of the water. Wet plaster softens and stops supporting the bone.
- Raise the limb above the level of the heart as much as possible for the first two to three days.
- Move the fingers or toes that are free, often.
- Do not push anything inside to scratch. For itching, blow cool air from a hair dryer into the cast.
- Do not trim the cast, put powder or lotion inside, or lean on it, unless told.
- Keep every follow-up visit, since X-rays may be needed as swelling falls.
Warning signs: when to come back or go to emergency
Do not wait for the next appointment if any of these appear.
- Pain that is increasing, or is not eased by raising the limb and the medicine advised.
- Fingers or toes that are swollen, pale, blue, cold or numb, that tingle, or that cannot be moved.
- A cast that feels too tight, or has become loose, cracked, soft or wet.
- Fever, a bad smell, fluid through the cast, or a burning spot under it.
- Pain or swelling in the calf with a leg cast. Breathlessness or chest pain with it needs emergency care at once.
Children's fractures in plaster
Children's bones heal faster than adults', and they often need a cast for a shorter time. They are still growing, so a fracture near the growth plate needs careful follow-up even when it looks minor. A cast can loosen as swelling goes down and the bone can slip, so planned review, sometimes with a repeat X-ray, is part of treatment. Some minor fractures, such as a buckle fracture of the wrist, may be managed with a removable splint or short cast.
Children cannot always say that the cast hurts. Watch for crying that does not settle, refusal to use the hand or foot, swollen or colourless fingers or toes, or a smell from the cast.
After the cast comes off
The limb looks thin, the skin is dry and the joint is stiff, which is expected after weeks without movement. Moisturise, move the joint gently, and ask about physiotherapy if stiffness persists. Many adult arm and leg fractures need a cast for several weeks and some bones longer, so do not have it removed early.
How to book
Plaster for a fracture is applied at Mahavir Health Campus, Athwa Gate. To book, use WhatsApp or the clinic and hours page, and bring the X-ray.