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Plaster Care

Looking after your child's plaster correctly is very important. The reason for the plaster is to keep your child's limb in the right position and to protect the injured area whilst healing occurs. A plaster is sometimes called a cast or plaster cast (all these names mean the same thing).

Occasionally there are some complications from the plaster and you need to know what to watch for and when to come back.

Care at home

Raise or elevate the limb

• In the first few days after discharge from hospital, keep your child's injured limb raised above the level of the heart and encourage your child to move their fingers or toes as much as possible. This will help to reduce the chance of further swelling and assist with pain relief.
• Always use the sling provided to support the arm when your child is up and walking around. Rest it on pillows when they are sitting or lying down.
• Raise a leg on pillows when resting and use crutches, a wheelchair or walking aids as instructed.
• Encourage plenty of rest in the first few days at home.

Skin care

• Itchiness under the plaster is common. Do not scratch under the plaster with sharp objects as they may cause a scratch which can easily become infected  e.g. knitting needles, pens. Distracting your child with something else is the best way to deal with itchiness.
• If the plaster develops a strong, awful smell and your child has a temperature this may be a sign of infection. Contact your local doctor or go to the emergency department of your nearest hospital.
• If an object has been pushed under the plaster, a pressure sore may develop. Go to the emergency department of the Royal Children's Hospital (RCH) or your nearest hospital.

Cast care

• Keep the plaster dry at all times.  When bathing, make sure that the plaster is totally protected with a plastic bag and well sealed at the top with tape. Never immerse the limb in the bath.
• The plaster usually takes 2 days to dry properly. During this time your child may experience a warm sensation under the plaster.
• Allow the plaster to dry naturally, keep it away from direct heat.
• Avoid damaging the plaster by resting it on hard surfaces or walking on it (unless otherwise instructed)
• Arm plasters need to remain under clothing and should not be threaded through sleeves until the doctor gives the OK at the one week follow up appointment.

What to watch for

Excessive pain

• Pain in the area of the fracture or operation site is quite normal for the first few days. Your child should be able to fully bend and stretch their fingers or toes without excessive pain.
• If your child's pain is not relieved by the recommended medications you should take them to the RCH emergency department or the hospital you attended.

Poor blood supply

• Poor blood supply may cause your child's fingers or toes to appear pale or bluish in colour, cool to touch, and they may say that they have pins and needles or numbness. They may not be able to move their fingers or toes.
• If your child has these symptoms, raise the limb above the level of the heart. If the symptoms still persist after 20 mins, go to the RCH emergency department or the hospital you attended.

Swelling

• Slight swelling of the fingers or toes may occur. Check the plaster at both ends to make sure that it is not too tight.
• Raise the limb above the level of the heart and encourage your child to move their fingers or toes.
• If your child has obvious swelling of the fingers or toes, raise the limb above the level of the heart. If the swelling has not decreased after 20 minutes, go to the RCH emergency department or the hospital you attended.
  

Follow up

For patients treated in hospital:

Before your child is discharged from hospital, you will be given details of their follow up by the nurse or doctor looking after your child.
Most children with fractures are usually seen 1 week after the injury in either:

• Fracture clinic (Orthopaedic Outpatients). It is recommended that you make your appointment in Orthopaedic Outpatients prior to leaving the hospital.
• The surgeon's private rooms.
• At your local doctor (GP).

For patients treated in emergency:

Please see your local doctor (GP) the day after the plaster has been applied so that it can be checked.

Key points to remember

• If your child's cast becomes loose, soft or cracked - call Orthopaedic Outpatients or present to the nearest emergency department.
• If your child has any symptoms in the 'What to watch for" section - present to the nearest emergency department.

Other sources of information

• 4 North: (03) 9345-5583
• Orthopaedic Outpatients: (03) 9345-5311
  Operating Hours: Monday to Thursday 9.00am-4.30pm
                                              Friday   8.30am-12.00noon
• "Plaster on and plaster off" -  Photos and information for children on getting a plaster put on and taken off.

Individual information