Splints and casts can help support, protect and immobilize the injured extremity while the broken bone (fracture) heals.  

What is the difference between a splint and a cast?

  • Splints are made out of plaster and can be easier to mold for some uses, such as holding the reduction of newly broken bones. They usually only go on one or two sides of an extremity, allowing for the injured area to swell without being constricted.
  • Casts are made out of fiberglass, a type of plastic that can be shaped. Fiberglass casts are typically lighter, more durable and go completely around the injured extremity. They are best used to hold broken bones a few weeks after an injury since circumferential casts are unable to expand with tissue swelling.

What can be done to reduce swelling?

Swelling normal occurs after an injury. This can cause the injured arm or leg to feel uncomfortable, tight, and have a throbbing feeling. To reduce swelling:

  • Elevate the affected area. For the first 24 to 72 hours after injury or surgery, it is important to elevate the injured extremity at or slightly above the level of your heart. This can be accomplished by placing a pillow or folded blankets underneath the splint or cast.  Constant elevation is needed to minimize the risk of swelling, even while sleeping.
  • Keep moving. Although the arm or leg is casted, it is important to frequently move the fingers or toes of the injured limb.
  • Apply ice. For the first 48 to 72 hours, loosely wrap an ice pack covered in a thin towel around the cast.  Apply ice to the cast, not the skin, at the area of injury for 15 to 30 minutes every few hours.  Take great care that the cast does not get wet

How to minimize itchiness under the cast?

A cast can cause the skin under it to feel itchy. To relieve itchy skin:

  • Stay inside and out of warm weather, this can minimize sweating and keep the skin comfortable
  • Using a hair dryer on a cool setting and aiming it under the cast can be helpful
  • Over-the-counter antihistamines can help reduce itchiness

Never stick any object, such as a coat hanger or stick, inside the cast to scratch the skin.  This could cause the skin to be unknowingly injured and can lead to infection.

What to do if the splint or cast gets wet?

It is very important to keep your splint or cast dry at all times. Special care must be given to it while bathing.  Any wetness on or underneath the splint or cast can lead to skin injuries that can become infected. If you accidentally get yours wet, notify your physician so that it can be changed. However, changing a splint or cast before the broken bones have healed places the fracture at risk of healing poorly or sometimes not at all.  

How to keep your cast in good shape?

  • Keep it clean. Keep dirt and sand away from the inside of the cast. Cover the cast while bathing or eating.
  • Skip lotions. Avoid placing powder, lotion or deodorant on or near the cast
  • Leave adjustments to the doctor. Don’t pull the padding out of the cast. Don’t trim the cast or break off rough edges without first asking you doctor.

What is the risks with having a cast?

The biggest risk to your arm or leg while in a cast is compartment syndrome. This occurs when swelling occurs, but the arm or leg is unable to expand because the circumferential cast restricts it.  The pressure underneath the cast can increase to a dangerous level where the tissue underneath cannot get the blood and nutrients it needs.  The end result can be serious, sometimes irreversible damage to the limb.

The best way to minimize this is to reduce the swelling to the limb by keeping it constantly elevated.

What to look out for?

Signs and symptoms that the pressure underneath the cast is may be too high:

  • Excessive swelling below or above the cast
  • Feeling increased pain or tightness in the injured limb
  • Increased numbness or burning in the fingers or toes
  • Being unable to move the toes or fingers of the injured limb

If any of these symptoms present, it is important to seek immediate medical attention. Call the office with any questions or concerns, or proceed to the nearest emergency room.