Casts are used to keep parts of your body still and in place after an accident or surgery so an injured bone (or bones) can heal. The following guidelines will help keep the cast in condition and support the healing process.

Do not

  • Get the cast wet – water will degrade the plaster and reduce its effectiveness. Cover the cast with plastic during showering or bathing – make sure it is sealed as tightly as possible.
  • Cut, rearrange or modify the cast (including the lining).
  • Place additional lining in or around the cast – the plaster should be handled as little as possible.
  • Insert objects (rulers, pencils, cutlery) inside cast to scratch an itch. This can damage the plaster, irritate your skin or cause further injury.
  • Use oils or oil-based lotions (such as moisturisers) or powders on the injured limb near the cast — they can degrade the plaster.
  • Play in sandpits or loose dirt – this could get into the cast and cause discomfort.
  • Take part in any vigorous activity – especially if it involves the damaged limb/cast area.

Do

  • Keep the injured limb above the level of your child’s heart for 48 hours after the injury or if swelling persists. For example, place an arm in a sling or rest a leg on a pillow.
  • Regularly move fingers/toes to promote blood flow and reduce swelling.
  • Exercise arms in slings regularly. Remove the sling every hour during to move the elbow and shoulder joints and prevent stiffness.
  • Learn how to use crutches. It is very important that crutches are used properly to avoid a fall or further injury.
  • Take care of the skin. Keep an eye on the condition of the skin around the cast area, look for any redness or deterioration.
  • Use pain relief – paracetamol or ibuprofen may be used as directed by a clinician.
  • Attend follow-up appointments. This is important for checking how the injured bone is healing.

Check sensation and circulation

  • Regularly check that the sensation (feeling) and circulation (blood flow) of the limb is OK. Touch the area above and below the cast several times a day. If your child complains of numbness, tingling or pain, the cast may be too tight ­– call your GP right away.
  • Have your child move or wiggle his/her fingers or toes frequently throughout the day to promote circulation and reduce swelling.
  • Press briefly on your child’s middle fingernail or large toenail several times a day to check circulation. When it turns white, let go. If pink colour does not return in 3 seconds, call your child’s doctor right away.
  • Check the temperature of the injured limb. If your child’s hand or foot is cold, cover it with a blanket or sock, or raise it above the level of the heart. Check again in 20 minutes. If it is still cold, check the sensation and circulation. If you think there might be a problem, call your child’s doctor right away.
  • Look for swelling above and below the cast every day. A little swelling is normal, but a lot of swelling is not. Compare the limb with the cast to the other one. If there is swelling, raise it higher than the level of the heart for one hour. If the swelling does not, contact your GP.

Seek urgent medical help

  • your child is experiencing pain that is not relieved by elevation of the limb or pain-relief medication
  • the fingers or toes of the injured limb remain white in colour when you press them or turn blue
  • the fingers or toes of the injured limb are painful, numb, tingling, swollen or not moving
  • your child develops a high temperature
  • a blister or sore develops inside the cast
  • there is an offensive smell from the cast area.

When to seek help

See your GP if:

  • the cast becomes very dirty or wet
  • the cast breaks, cracks or develops soft spots
  • the cast becomes loose and starts to move around
  • skin problems are developing at the cast edges.

In an emergency, call Triple Zero (000) and ask for an ambulance.

If you're not sure whether to go to an emergency department, call 13 HEALTH (13 43 25 84) and speak to a registered nurse.

Developed by the Orthopaedics Outpatients and Emergency departments, Queensland Children’s Hospital. We acknowledge the input of consumers and carers.

Resource ID: FS079. Reviewed: June 2022.

Disclaimer: This information has been produced by healthcare professionals as a guideline only and is intended to support, not replace, discussion with your child’s doctor or healthcare professionals. Information is updated regularly, so please check you are referring to the most recent version. Seek medical advice, as appropriate, for concerns regarding your child’s health.

Last updated: December 2023