Cast Care for Children

About your child's cast

A cast holds a broken bone (or a healing surgery) still and in the right position so it can heal. It is usually made of fiberglass with soft padding underneath. Good day-to-day care keeps the cast working well and protects your child's skin.

Reduce swelling (first 1–2 days)

• Keep the casted arm or leg raised above the level of the heart as much as possible.
• Place an ice pack against the cast (never directly on the skin, and not on top of the cast in case of leaks) for the first 24–48 hours.
• Encourage your child to wiggle the fingers or toes often.

Keep it dry

• Keep the cast clean and completely dry — a wet cast softens, loses its shape, and can harm the skin.
• Cover the cast with a plastic bag or a commercial cast cover for bathing, and keep it out of the water. Sponge baths are safest.
• If the cast gets wet and stays damp, soft, or cracked, call our office.

Protect the skin

• Do not let your child put anything inside the cast (no toys, coins, food, or sticks) — this can injure the skin and cause infection.
• Do not use powder or lotion inside the cast or at the edges.
• For itching, set a hair dryer to COOL and blow air into the cast — never use a hot setting and never poke objects inside.
• Check the skin at the cast edges each day for redness, blisters, or sores.

Walking casts

• Do not let your child walk or bear weight on a leg cast unless your surgeon has said it is okay.
• If a walking boot or heel was applied, use it exactly as directed.

Call our office right away if you notice

• Fingers/toes that are cold, pale, gray, or blue, or that your child cannot move or wiggle
• Numbness, tingling, or burning that does not get better after raising the limb
• Pain that keeps getting worse and is not controlled by the prescribed medicine and elevation
• Fever of 101°F (38.3°C) or higher, or shaking chills
• Swelling that does not go down with rest and elevation
• Increasing pain, numbness, tingling, or burning that does not improve with elevation and rest
• Toes or fingers that are cold, pale, gray, or blue, or that your child cannot move
• A foul smell, drainage, or a warm spot on the cast (possible skin sore or infection)
• Skin that is rubbed raw, blistered, or sore at the cast edges
• The cast is cracked, broken, soft, too loose, or too tight, or has a rough edge
• An object is stuck inside the cast that you cannot remove

Call 911 right away if your child has

• Trouble breathing or shortness of breath
• Chest pain
• A pale, gray, or bluish color to the lips or face that does not improve

Follow-up

Keep all follow-up appointments. The cast is removed in the office with a special saw that vibrates and cannot cut the skin — it can feel buzzy and warm but does not hurt. Your provider will tell you how long the cast stays on.

Learn more

For pictures and a family-friendly overview, see the OrthoKids resource linked on this page (OrthoKids: Casts and splints). It is provided by pediatric orthopaedic surgeons.