A cast keeps a broken bone in place so it can heal. Plaster casts are heavier than fiberglass casts. But plaster casts shape better. This gives better support for certain fractures, such as broken bones in a hand.
Casts are custom made. A cotton or synthetic lining is gently put around the fracture. This protects the skin. Moistened plaster tape is put in layers on top of the lining. The rough edges of the cast are covered with the lining or cotton gauze. Plaster casts may take several days to dry, depending on the size of the cast. You must take care to help the cast dry and to prevent dents. Children can go back to some of their normal activities once the cast is dry.
Home care
Follow these guidelines when caring for your child at home:
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Your child’s health care provider may prescribe medicines to ease pain and itching. Follow the provider’s instructions when giving these medicines to your child.
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Make sure the cast dries. Keep it uncovered for a few days. For larger body casts, you may need to turn your child every few hours. On humid days, you can use a hair dryer set on cool to help dry the cast. Limit how active your child is until the cast dries.
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Handle a wet cast carefully. To prevent dents, hold the cast with the palms of your hands instead of your fingers.
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Have your child sit or lie down and raise the injured area above heart level as often as possible for the first few days. This will help reduce swelling. Use a sheet of plastic to protect pillows from a wet cast.
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Put ice bags or packs around the cast to reduce swelling or ease itching. You can make an ice pack by wrapping a plastic bag of ice cubes in a thin towel. As the ice melts, be careful that the cast doesn’t get wet.
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Look at the cast every day for any damage, such as a soft or flat area, flaking, or cracking.
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Check the skin around the cast several times a day. The skin should look healthy and not be swollen. Your child should be able to move all fingers and toes.
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Have your child wiggle toes or fingers or tighten and loosen muscles several times a day. This will help increase blood flow.
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Don’t let your child put objects inside the cast. Also don’t let the child stick anything inside the cast to scratch an itch.
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Reduce itching by distracting your child. It may help to scratch the opposite limb or scratch the skin outside of the cast.
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Keep the cast dry at all times. Have your child bathe with the cast well out of the water. Protect it with two large plastic bags. Separately close the top end of each bag with a rubber band or tape.
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Don't break off any edges of the cast. Only the provider should adjust or remove a cast.
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Look at the skin underneath the cast for the signs of infection listed below. Use a flashlight to help you see.
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If your child has a hip or large leg cast, talk with the provider about tips for how to use the toilet and how to prevent skin irritation.
Follow-up care
Follow up with your child’s health care provider as advised.
When to get medical advice
Contact your child’s health care provider right away if your child has:
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A fever (see "Fever and children" below).
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Chills.
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A cast that seems too tight or too loose.
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A wet or soggy cast.
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Pain gets worse or doesn’t get better when taking prescribed pain medicine.
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Pale color or other skin color changes around the cast.
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Numbness or tingling near or under the cast.
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Signs of infection, including redness, swelling, pain that gets worse, warmth, or a foul-smelling fluid that drains from the cast.
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A cast that feels warm on the surface.
Fever and children
Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:
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Rectal. For children younger than 3 years, a rectal temperature is the most accurate.
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Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The health care provider may want to confirm with a rectal temperature.
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Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.
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Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.
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Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.
Use a rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel okay using a rectal thermometer, ask the provider what type to use instead. When you talk with any health care provider about your child’s fever, tell them which type you used.
Below is when to call the provider if your child has a fever. Your child’s provider may give you different numbers. Follow their instructions.
When to call a health care provider about your child’s fever
For a baby under 3 months old:
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First, ask your child’s health care provider how you should take the temperature.
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Rectal or forehead: 100.4°F (38°C) or higher
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Armpit: 99°F (37.2°C) or higher
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A fever of ___________as advised by the provider
For a child age 3 months to 36 months (3 years):
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Rectal or forehead: 102°F (38.9°C) or higher
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Ear (only for use over age 6 months): 102°F (38.9°C) or higher
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A fever of ___________ as advised by the provider
In these cases:
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Armpit temperature of 103°F (39.4°C) or higher in a child of any age
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Temperature of 104°F (40°C) or higher in a child of any age
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A fever of ___________ as advised by the provider
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