"The greatest glory in living lies not in never falling, but in rising every time we fall." - Nelson Mandela
#1. Do's
Keep moving your fingers/toes in the cast as much as possible, to prevent stiffness and help with the blood circulation.
Keep the limb elevated. (For a upper limb cast: Use a sling during the day or place the upper limb over the chest while sleeping . For a lower limb cast: Use two two pillows to elevate your limb).Tip: the logic is to keep the affected limb above the level of the heart.
Keep your cast dry, if you accidentally get the cast or the padding wet, do not hesitate to get your cast changed.
Always consult your doctor before you start weight bearing.
kindly consult your doctor if you lose a pencil or a piece of stick in the cast, cause that can result in wound inside the cast that can get infected.
If there Is softening of the plaster cast, please get the plaster cast redone to prevent displacement of the fracture.
Weight bearing on a cast : A POP( Plaster of Paris)cast takes two days to get completely cured, where as a fibreglass(Articast)cast takes 30min to 1hr.
#2. Risk of compartment syndrome
Make sure the cast is firm and not too tight. There is a risk of compartment syndrome on day 1. If you feel the cast is tight, please be aware for signs of compartment syndrome:
Sudden increase in the pain.
Increase in swelling, onset of tingling and numbness in the extremity.
Inability to move fingers/ toes .
Bluish discoloration of fingers or toes .
#3. I think I have a compartment syndrome what should I do?
The cast along with the cast padding has to be split open urgently, hence visit your doctor immediately.
Tip: If you are staying far away from the nearest hospital, soak the POP cast in a water and unwrap the POP bandage and the circumferential padding .
#4. Don’ts
Occasionally you may experience severe itching, dont no try to use a pencil, a ruler, or any other object to scratch around , you could end up with a wound which could get infected inside of the cast.
Dont try to weight bear unless you be instructed to do so, cause fracture displacement can occur in the cast, leading to a deformity or a malunion.
Dont expose your cast to water, as wetting the cast from the outside can weaken the cast and wetting the padding inside the cast can contribute to maceration of the skin, which can slow wound healing and make skin vulnerable to skin infection.(1)
#5. Rehab while in a cast.
Goals:
To protect the fracture.
To achieve maximum possible functional range of movement in all joints.
Strengthening of the muscles of the involved limb.
Faster Recovery.
It is recommended that you move the joints that are not part of the cast.
Below elbow cast : move your fingers, move your elbow, and your shoulders
Above elbow cast: move your fingers and shoulders.
Below knee cast: move your toes, bend and straighten your knees. Static quads exercises (click to know more) to prevent wasting if muscle of the thigh.
Above knee cast: move your toes, static quads exercises (click to know more) in the cast. (Note: weight bearing should be started only after a consultation with your doctor)
#6. How many times and how long should I exercise.
1-3 sets, with 10 repetition per set, a minimum of once a day but twice a day will be really beneficial.
References:
White RJ, Cutting KF. Interventions to avoid maceration of the skin and wound bed. Br J Nurs. 2003 Nov 13-26;12(20):1186-201. doi: 10.12968/bjon.2003.12.20.11841. PMID: 14685125.
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