Pediatrics Common Questions, Quick Answers

Splints and Casts

Donna D'Alessandro, M.D.
Lindsay Huth, B.A.
Peer Review Status: Internally Reviewed
Creation Date: April 2002
Last Revision Date: April 2002

• What are splints and casts?
• Why does my child need one?
• What are the risks?
• How is it put on?
• How is it taken off?
• Is it painful?
• What care will my child need?
• How do we care for it?
• When should I call the doctor?

What are splints and casts?

• Splints and casts are like big bandages that are used to treat injured bones.
• They are wrapped or fitted to an injured area.
• They hold the injured area in place so that it heals correctly and cannot move.

Why does my child need one?

• Casts and splints hold an injured bone in place so that it can heal correctly.
• They support and protect injured bones.
• They help reduce pain and swelling.
• Your doctor will decide whether a cast or splint is best for the injury.

What are the risks?
After a cast or splint is put on, watch for signs that there may be a problem. Sometimes, the cast does not fit right. If you notice any of the following symptoms, call your doctor immediately:

• Increased pain
• Feeling that the cast or splint is too tight
• Numbness or tingling in the hand or foot of the injured area
• Burning and stinging
• Much swelling below the cast, in the fingers or toes
• Loss of movement in fingers or toes
• Fingers or toes are cool
• Fingers or toes turn bluish or gray
• Skin under the cast is a strange color or odor

How is it put on?
Splints and casts are put on by a doctor or other trained assistant. Your child may need X-rays first.

Splints

• Splints can be made new to fit your child, but often they are already made and then adjusted.
• For example, some can be adjusted using Velcro straps.
• Since they can be adjusted, splints are helpful if the injured area is swollen. The splint can be made larger or smaller so that it fits the injured area correctly.
• They come in many shapes and sizes.
• Sometimes, a strap is attached to the splint and goes around the neck to help hold the arm.
• They are easier and faster to use than casts.
• They are easier to take on and off.
• The splint can be easily taken off so the injured area can be exercised as it continues to heal.

Casts

• First, a soft layer of padding is put against the skin of the injured area.
• Next, strips of fiberglass or plaster are dipped in water. They are put over the padding. When it dries, the cast turns hard.
• The cast holds the injured bone in place so that it can heal correctly.
• After swelling to the injured area goes down, the cast might be too big. A new cast may be needed.
• Casts can also become too tight if swelling increases.
• After awhile, the doctor might decide to begin using a splint. The splint can be easily taken off so the injured area can be exercised as it continues to heal.

How is it taken off?

• Your child will probably have to wear the splint or cast from a few weeks to a few months.
• A doctor or trained assistant should take off the cast. Never do it at home.
• The doctor uses a round saw to remove a cast. The saw makes a loud noise. It shakes, but does not turn. It does not cut the skin.
• The padding will protect your child's skin.

Is it painful?

• Removing the cast is not painful. The saw makes a noise that sometimes scares children but it does not hurt. It may make the area warm.

What care will my child need?

• After a splint or cast is put on, elevate the injured area for 24 to 72 hours.
• Raise it above the heart. Prop it up on a pillow or something else. If your leg is injured, you should sit reclined (leaning back) or lay down.
• Move the fingers and toes of your uninjured arms and legs gently, and often.
• Put ice on the cast or splint. Put the ice in a plastic bag and wrap it loosely around the injured area.

How do we care for it?

• Some casts and splints are waterproof. Ask your doctor how wet it can get.
• Other casts and splints should be kept dry.
• Cover it with two layers of plastic to keep it dry while your child bathes.
• Children should not play on wet grass or sand.
• Cover the cast in wet weather.
• Do not cover a new cast that is still drying.
• Do not walk on a "walking cast" until it is dry. It takes about one hour for a fiberglass cast to become hard and about 2 to 3 days for a plaster cast to become hard.
• Keep the cast or splint clean. Do not let dirt, sand, or powder get inside it.
• Do not stick anything inside it, such as coat hangers, to scratch the skin. If it is itchy, use a blow-dryer set on "cool" and let the air blow inside the cast.
• Do not put powders or lotions near the skin of the cast or inside to ease itching.
• Do not break off, trim, or sand rough edges of the cast. Cover the rough edges with tape and call the doctor.
• It's okay to use markers to sign the splint or cast.

When should I call the doctor?

• Call the doctor if the skin under the cast is itching and it can't be relieved.
• Call the doctor if your child has any of the symptoms listed under "Risks" above.
• Call your doctor if the cast has rough edges, is cracked, or has soft spots. Cover rough edges with tape until you can see a doctor.
• Call the doctor if the skin around the cast becomes red or raw.
• Call the doctor if you have questions about how to care for the cast or splint or how to keep it dry.
• Call the doctor if you have questions or concerns about your child's condition.

Quick Answers

• Splints and casts are like big bandages that are used to treat injured bones.
• They hold an injured bone in place so that it can heal correctly.
• After a cast or splint is put on, watch for signs that there may be a problem such as increased pain, numbness, or swelling in the fingers or toes.
• Splints and casts are put on by a doctor or other trained assistant.
• The doctor uses a round saw to remove a cast. Splints are easier to take off.
• Removing the cast is not painful but the saw often scares children.
• After a splint or cast is put on, elevate the injured area for 24 to 72 hours.
• Some casts and splints are waterproof. Others should be kept dry. Ask your doctor.
• Call your doctor if you have concerns about your child's condition or questions about how to care for the cast or splint.

References

• American Academy of Orthopaedic Surgeons. Care of Casts and Splints. 2000 (cited 2002 March 21). URL: http://www.aaos.org/wordhtml/pat_educ/castcare.htm
• Rutherford, K. Cool Cast Facts. KidsHealth. 2001 November (cited 2002 March 21). URL: http://www.kidshealth.org/kid/feel_better/things/casts.html
• Rutherford, K. The Facts About Fractures and Broken Bones. KidsHealth. 2001 August (2002 March 21). URL: http://www.kidshealth.org/kid/ill_injure/aches/broken_bones.html
• Sullivan C, Scherf S. The Do's and Don'ts of Cast Care. University of Chicago Children's Hospital. (cited 2002 March 21). URL: http://www.ucch.org/ucch/healthpages/surg/cast1.html

See related Patient Topics Bones, Joints and Muscles, Dislocations, Fractures, Injuries and Wounds, Procedures and Therapies or Rehabilitation.

See related Provider Topics Bones, Joints and Muscles, Fractures, Injuries and Wounds or Procedures and Therapies.

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