Fracture Cast Care

Summary

A fracture is a partial or total break in one or more bones. Fractures are usually caused by a large force or sudden stress exerted on the bone. They are typically accompanied by a lot of pain, swelling and bruising. Fractures are confirmed by an X-ray scan. In case of complex fractures, an MRI scan and CT scan will also be required. Bone healing occurs naturally. Fracture treatment aims to provide the bones with the right conditions to heal. This means aligning the broken bones correctly, and protecting the broken bones from further impact. This is done by putting a cast on the broken bone. The cast can be made of plaster or fibreglass. It needs to be protected from water. Getting the cast can weaken it and make it start disintegrating. Don’t put any weight on the cast. Learn to use crutches or other mobility assistance devices while you have the cast on. It is also important to keep the cast clean, and apply ice in case of swelling.

What is a Fracture?

A fracture is a partial crack or complete break in a bone. Bone fractures are usually caused by the impact of a large force or a large stress. Fractures can occur in any of the 206 bones in the human body. Fractures are typically accompanied by pain, swelling and bruising. Usually if you have a fracture, you will not be able to move or put any weight on the affected area. Fractures may be caused as the result of a fall, an accidental injury, or any other physical trauma to the body. There are many types of fractures such as:

1. Simple fracture – This is when a bone is broken but the skin around it is intact.
2. Compound fracture – This occurs when a bone is broken with such force that it pierces through the skin, resulting in an open wound.
3. Compression fracture – In this case the bone is crushed, causing the bone to be wider or flatter at the site of injury.
4. Segmental fracture – The bone is broken into 3 pieces, resulting in an “unsupported” section of bone in the middle.
5. Harline fracture – This is a thin, partial crack in the bone. It would look like a hair on the X-ray
6. Stress fracture – Repeated stress on a joint can cause a fracture. This happens a lot in the athletic community.
7. Pathological fracture – This happens when an underlying condition, like osteoporosis or bone tumours, result in a weak spot on the bone which then becomes fractured under the effect of smaller forces.

Fracture Diagnosis and Treatment

If you have a fall or an injury, it is a good idea to visit an orthopaedic specialist immediately, especially if you are in a lot of pain. Even if you have not broken any of your bones, you may have torn a ligament (sprain) or a tendon(strain). Sprains and strains can affect mobility as much as a fracture.

Once at the hospital, your doctor will diagnose your injury based on a full medical history, a detailed account of how the injury occurred, and a physical exam. They will also require an X-ray scan to check for broken bones. In some cases, an MRI scan or a CT scan may also be needed to assess the full extent of your injuries.

Bone healing occurs naturally in most cases. The treatment aims to provide the injured bone with the right conditions to heal correctly. This means putting any dislocated bones or joints back in their correct place. This process s known as “reducing the fracture”. The treatment will also provide pain relief and prevent any further injury from occurring during the healing phase. The broken bone is immobilised with a splint or a cast to keep the bone in its correct alignment during healing. The cast also protects the injured area from further impact. In some cases, internal or external fixation devices may be used. These are metal rods, plates or screws (usually titanium) which pin the bones in place while the fracture heals. These fracture fixation devices could be a permanent insert, or be surgically removed once the bone has healed. Fractures can take months to heal, as the body needs time to re-grow bone fibers and bone marrow to bridge the broken parts.

Fracture Cast

A cast is the most common treatment for a fracture. The cast firmly holds the broken bone in place, stabilising it during the healing phase. This ensures that the bone doesn’t heal with a permanent misalignment. Casts may be fitted for a broken ankle, knee, arm, elbow, wrist, hand or foot. Casts can be made of either plaster or fibreglass. Fiberglass casts are lighter and more durable than plaster casts. They are also more porous, which means air can circulate through them. This makes them more comfortable to wear. In some cases of complex fractures, plaster casts may be recommended because they are easier to mould precisely into the contours of the joints. Temporary casts are also usually made of plaster, because they are cheaper. Unlike splints, casts cannot be taken off or adjusted for the entire duration of the healing process. This is why it’s so important to take care of them the right way.

Fracture Cast Care

The cast stays with you for a while, so it’s important to take proper care of it. Here are some tips for good fracture cast care:

1. Keep it dry – Casts tend to disintegrate if they get wet. Also, if moisture seeps into the cast, it can take a very long time to dry. In this time, skin rashes and fungus can begin to develop inside the cast, which is undesirable. To keep the cast dry, wrap it securely in a plastic wrap before bathing. Try to avoid using the overhead shower, and opt instead for a bucket bath. This way you can target water at the rest of your body without getting any on the cast. There are also silicon and plastic cast guards available to give you a watertight seal around the cast while bathing. Even with all these precautions, sometimes the edges of the cast can get wet. If this happens, dry it immediately with a blow dryer on the cool setting. Don’t use the hot setting as this can cause burns on the skin.
2. Avoid putting weight on the cast – If the cast is on your leg or foot, you should not put any weight on it at all until it has hardened completely. Once it has hardened, it is still not advisable to walk on it, as this will transfer some of the load onto the injured foot. Use crutches or other walking assists instead. For the entire duration that you have the cast on, avoid strenuous physical activity and any activities that could damage the cast.
3. Don’t insert objects into the cast – When you have a cast on, the skin covered by it can get itchy. This is partially due to the sweat from your skin remaining trapped under the cast, but it can also be psychological. No matter how annoying the itching gets, DO NOT insert any objects, such as hangers, pencils, rulers or back scratchers, into your cast to scratch the skin. If its terribly itchy, you can blow air into it with your hair dryer on the cool setting. Never use the hot setting on the hair dryer to do this, as it can cause burns on the skin.
4. Keep the cast clean – Avoid getting sand or dirt inside the cast. While eating or engaging in any messy activity, you can wrap the ends of the cast in plastic wrap to prevent any dirt from getting in. Dirt or organic material that gets into the cast can cause skin infections. Do not put baby powder or lotion into or near the cast.
5. Apply ice if the cast gets too tight – The cast may feel tight on the first few days after it is applied. This is due to swelling. Apply ice to bring down the swelling. Elevating the fractured limb by propping it up on pillows will also help reduce swelling. A tight cast for extended periods of time can also cut off blood circulation and cause some numbness to the area. If this happens, go to the doctor immediately.
6. Never remove a cast on your own – If your cast is cracking or breaking off in chunks, do not remove it yourself. Visit the doctor for removal and replacement of the cast.

When to go to the doctor

If you notice any of the following things happening to your cast, consult your orthopedic specialist immediately:

Increasing pain or tightness in the injured limb – Slight tightness is normal, but it should go down with ice and elevation of the limb. If the tightness persists and causes you pain, there is likely excessive swelling which needs to be addressed immediately.

Inability to move fingers or toes – This could indicate that the cast is too tight and blood circulation is being cut off. Fingers and toes turning blue also indicates the same.

Cracks, soft spots or a foul smell – If your cast starts showing any of these signs, it is likely it has gotten wet and damaged. The cast will have to be removed and replaced.

The cast gets wet – If the cast is completely wet, it will cause a lot of problems. The inside of the cast will not dry even with a blowdryer on the cool setting, causing skin infections and bacterial growth. Water also weakens the cast.

Skin discolouration around the cast – Redness or raw skin around the cast is a red flag.

Should you suspect a fracture or require any orthopaedic assistance, remember, the team of dedicated and skilled professionals at Kauvery Hospital are always ready to help. With branches located across Chennai, Hosur, Salem, Tirunelveli, and Trichy, quality medical care is never far away. Trust us to provide comprehensive care for all your bone health needs, backed by our years of experience and understanding in the field.

Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai (Alwarpet & Vadapalani), Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.

Chennai Alwarpet – 044 4000 6000 •  Chennai Vadapalani – 044 4000 6000 • Trichy – Cantonment – 0431 4077777 • Trichy – Heartcity – 0431 4003500 • Trichy – Tennur – 0431 4022555 • Hosur – 04344 272727 • Salem – 0427 2677777 • Tirunelveli – 0462 4006000 • Bengaluru – 080 6801 6801