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Suggestions for follow-up care of fractures and cast care

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Topic: General Child Health

This handout was written to answer some of the questions most often asked about follow-up care for a fracture (broken bone) and cast care.

HOW SHOULD I TAKE CARE OF MY CHILD AT HOME?
Remember, the cast holds the broken bones together. The cast is very fragile, so it is important to give it the best possible care. Do not allow your child to walk on the cast unless it is modified for walking by the doctor.
1. Elevate the cast or splint: When a cast or splint is applied, it is important to elevate (put up) on pillows the broken arm or leg for 48 hours. Fractures should be raised above the level of the heart. This helps to relieve pain and decrease swelling.
a. If a foot or leg is hurt, keep it elevated (up) on pillows while lying down.
b. If a hand, wrist or elbow is hurt, keep the arm elevated (up) on pillows above the level of the shoulder, with fingers higher than elbow.
2. Ice bags: Place ice bags intermittently (on 1-1/2 hours, off 1 hour) on the cast over the injured area for 24-48 hours. Be sure to wrap the ice bag with a washcloth or towel. This will prevent the cast from getting wet and prevents any cold injury to the skin.
3. Keep the cast clean and dry: If you spill something on the cast, keep it uncovered until it dries.
4. Do not paint on cast: Painting will cause poor air circulation under the cast and will cause your child discomfort.
5. If the cast is itching: Do not use powder or cornstarch inside the cast. If the cast is itching, a hair dryer set on “cool” and directed under the cast may provide some relief. Do not stick anything down in the cast to scratch, in doing so, this can cause disruption of the padding, that can lead to severe skin problems.
6. Skin Care: Clean the skin around the cast with soap and water. Dry the skin with a towel. You may use lotion if your child’s skin is dry. If your child has a leg cast, cover his or her toes with a sock for warmth.
7. Do not put anything into the cast.
8. Check the circulation:
Check the circulation (blood flow) to the casted arm or leg by comparing it to the unbroken one. Check every hour for 24 hours.
a. Color - is the area above or below the cast your child’s normal skin color?
b. Warmth - do the toes/fingers below the cast feel warm to the touch?
c. Sensation - Can your child feel you touching his toes or fingers below the cast?

WHEN SHOULD I CALL THE DOCTOR/NURSE PRACTITIONER?
You should call your child’s doctor or nurse practitioner if your child complains or you notice any of these symptoms:
1. Fever
2. Numbness, tingling or swelling of the casted arm or leg
3. Foul odor from the cast or drainage from the cast
4. The skin around the cast is red or bluish in color or feels cold to the touch.
5. Pain not relived by acetaminophen. (Tylenol®, Tempra®, Liquiprin® or Panadol®).

HOW WILL MY CHILD’S SKIN LOOK AFTER THE CAST IS TAKEN OFF?
The skin under the cast will look funny to you, but do not be alarmed. The skin will be lighter in color than the rest of your child’s skin. It will be dry and scaly. For the next few days, you will need to soak your child in the tub to help the scaly skin. After soaking, pat the skin dry and apply lotion. Do not pick or pull at loose skin. This will cause bleeding and can lead to an infection.

The information contained in this handout is for general information only and should not be considered complete. For specific information on fractures/cast care, please ask your doctor or nurse practitioner.

PDF: SUGGESTIONS FOR FOLLOW-UP CARE OF FRACTURES AND CAST CARE

Derechos de autor(c) de The Children's Medical Center, ano 1999. Este material unicamente tiene fines educativos. No puede ser reproducido, distribuido ni modificado sin previa autorizacion de The Children's Medical Center of Dayton, One Children's Plaza, Dayton, Ohio, 45404-1815. Llame al 937-641-3666 para solicitar autorizacion o para obtener un juego maestro para copias. Para obtener mas informacion puede visitar www.childrensdayton.org (consulte la seccion de informacion legal).

La informacion contenida en este material es unicamente informacion de tipo general. No debe considerarse como completa. Para obtener mas informacion acerca de los complementos para leche materna, por favor pidala a su doctor.
Corregido: 1994, 1998, 2000
Revisado: 2002, 2005

The information contained in this handout is for general information only and should not be considered complete. For specific information about bathing your baby, please ask your doctor or nurse practitioner.

Additional information may be located in the Family Resource Center, 2nd floor, near the Outpatient Surgery Center. Hours of the center vary; please contact the Family Resource Center at 937-641-3700.

Copyright(c) The Children's Medical Center of Dayton. This material is for educational purposes only. It cannot be reproduced or distributed without permission from Dayton Children's.
Revised: 1994, 1998, 2000
Reviewed: 2002, 2005

 

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