Cast Care

Your child has been placed in a cast because of an injury or surgery to a bone or muscle. There are some issues that need to be addressed to assure your child's safety and comfort. The Division of Orthopaedic Surgery at Cincinnati Children's provides information about caring for your child who has a cast.

A regular (non-waterproof) cast becomes firm to the touch within 10-15 minutes after it is put on, but for the first two hours it is soft and can easily be dented or cracked. If your child has a walking cast (weight-bearing cast), he or she should not walk on it for two hours after it is applied.

Do not place the cast under water.  An arm or leg cast can be protected from splashing with a large plastic bag during bathing. Cover cast with the bag and tape the opening shut. Even with a cast covered, your child should not place the covered cast in the water. Special plastic covers can also be bought, but they can leak when placed under water. It may be easier for your child to take sponge baths while the cast is on.

If the cast becomes soiled, it can be cleaned with a slightly damp washcloth. Your child should not put clothing over the cast until it dries. Protect the cast by covering it when your child eats or drinks. If a cast gets wet, immediately dry it with a blow dryer on the cold or cool setting. Children can be burned with a blow dryer on the warm or hot setting. 

If your child has a large cast, changing his or her position is important. This will prevent constant pressure on any one skin area. Turn the child every two hours during the day and as often as you can at night. It also helps to put the child's casted arm or leg up on a pillow.

Check your child's skin every day. Press skin back around all edges of the cast. Use a flashlight to give more light and carefully look under the cast for reddened areas. Feel for blisters or sores under the edges of the cast. Rub the skin under the edges of the cast with rubbing alcohol three to four times a day. This will help toughen it. If the skin becomes cracked or very dry, stop using the alcohol until it is clear. Do not use lotions or powders on the skin. These tend to cake and will soften rather than toughen the skin. This may injure the skin.

Do not allow your child to stick any object, such as a pencil or a coat hanger, under the cast. Call your doctor about unbearable itching. Children's Benadryl can help with the itching and is available at drugstores without a prescription. You can also use a vacuum cleaner with an upholstery attachment. The vacuum will pull air through the cast, which is porous, and will relieve the itching.

The only cast that can go into water is a waterproof cast. It can get completely wet in the bath, shower, sprinkler, rain, or pool. There is no need to dry the cast, but it should be rinsed after being in the pool or in soapy water. Unfortunately, waterproof casts are not for all types of fractures, or for recently manipulated fractures.  Waterproof casts are usually not applied after surgery.

It is normal for the fingers or toes to appear slightly darker than the opposite side for the first 30 minutes after application of a waterproof cast.

Children with leg casts may be taught to walk with crutches or to use a walker. Your doctor will decide if your child is allowed to walk, or put weight on the cast.

When there is a cast in place, it is important to check the function of the nerves and blood vessels. Your child's fingers and toes should be pink and feel warm to the touch. A gentle squeeze should cause the finger to blanch (turn white) followed by a return of color when released. Your child should be able to feel all sides of his or her fingers when touched. Your child should also be able to wiggle his or her toes or fingers.

  • Toes or fingers are cold to touch, appear pale, or blue
  • The child complains of tingling or numbness of toes or fingers
  • The child cannot move toes or fingers
  • Toes or fingers become very swollen
  • Your child complains of rubbing or burning under the cast. This can be a sign of a pressure sore (especially over the heel or ankle).
  • There is a foul smell from the cast or if staining of the cast occurs that was not present when the child went home. This may be a sign of a pressure sore and should be checked by your doctor.
  • There is a breakdown of skin under the edge of the cast
  • The cast is too loose or too tight
  • The cast breaks, becomes soft or cracks, or wears out
  • The non-waterproof cast is soaked and does not dry with a vacuum or blow dryer on the cold setting

If you need to reach the orthopaedic nurse before 4 pm Monday through Friday, call 513-636-4567. After 4 pm and during weekends and holidays, call 513-636-4200 and ask that the orthopaedic resident on call be paged.


Last Updated 07/2013