Taking care of your child’s cast
This brochure provides essential information on how to care for your child’s limb when it’s in a plaster or fiberglass cast. Depending on your child’s specific needs, your doctor may give you additional or different instructions tailored to their treatment.
It is important to follow the advice given by the doctor or nurse. Do not hesitate to ask if you have any questions – your child’s comfort and recovery are our top priority.
General cast care guidelines
1. Keep the cast dry
- Allow the cast to dry naturally; avoid direct sunlight and try to stay indoors when possible
- When your child showers, completely cover the cast with a waterproof plastic bag to protect it from getting wet
- Never let the cast become soaked, as moisture can lead to skin irritation or even infection around the wound
2. Raise the plastered/casted limb when your child is resting
This can be done by placing pillows underneath the affected limb.
3. Minimise movement for small children
For children unable to use crutches, carry them to minimise movement. Excessive movement can lead to sweating, making the child prone to itchiness.
4. Encourage your child to exercise his/her fingers and toes
This helps reduce swelling and improves blood circulation.
5. Managing severe itching
- Keep your child in a cool environment, as the itch and odor are often caused by sweat trapped under the cast
- Use a hairdryer on the cold setting or a fan to help dry the area
- If these methods do not help, consult your doctor about anti-itch medications, such as antihistamines (these medications may not completely relieve the itch and should be used only when necessary)
6. Do not trim or modify the cast
The cast is designed to provide proper support for healing. Altering it may delay your child’s recovery.
7. Avoid inserting anything in the cast
It is normal for the cast to cause mild itching, but your child should never insert anything to scratch inside. This can lead to serious skin damage
Specific cast care guidelines
1. For non-walking casts
Avoid placing weight on non-weight-bearing casts. Crutches should be used for support.
2. For walking casts
Do not allow jumping, running, or tiptoeing while using a walking cast.
3. For casted lower limbs
- Elevate the affected limb to reduce swelling
- Drink plenty of fluids
- Wiggle or exercise the toes often to reduce the risk of blood clots
4. For casted upper limbs
- Elevate or support the limb with a blanket or pillow
- Exercise the fingers regularly to reduce hand swelling
5. Bandages
Leave all bandages intact until your child’s scheduled appointment.
6. When to seek medical attention
- Loose, cracked, or broken cast
- Numb, cold, or discoloured(blue) toes or fingers
- “Pins and needles” sensation or numbness in the limb
- Stained or smelly cast
- Severe or persistent itching
Additional cast care tips
- A sling will be provided to support your child’s upper limb while moving
- For lower limb fractures, crutches are recommended
- Ensure that toes and fingers remain pink and warm
- Your child may experience some discomfort at home. A mild painkiller like paracetamol can be given as prescribed
- Cover walking casts with fully strapped sandals when your child is walking
Travelling with a cast
- Check with the doctor to see if it is safe to fly with a cast
- Inform the airline about your child’s condition and any assistance you may need before the
trip - A full cast usually needs to be split or bivalved before flying to allow for swelling during the
flight (due to air pressure at high altitudes). This is necessary if:
– The cast was applied less than 48 hours before the flight
– The flight duration is longer than 4 hours
Dr Lam Kai Yet
Dr Lam is an experienced and accomplished paediatric orthopaedic surgeon who is actively involved in research in paediatric trauma, limb lengthening, and deformity correction, sports injuries, and 3D-printing.
He is dedicated to bringing a new level of expertise and care to the emerging field of paediatrics orthopaedics in Singapore. He has amassed experience in this specialised field, through his practice in KKH, as well as overseas fellowships, specialised trainings, and conferences.
He believes that care should be tailored to one’s individual and unique needs.
