Looking after your child in a plaster cast 

Your child needs a plaster cast to keep a particular part of the body immobile/still. It may restrict your child’s movement and activities while the area heals.

Please note that the type of care your child needs depends as much on his or her condition or illness as on the operation he or she has had at Great Ormond Street Hospital (GOSH).

What do I need to do?

Do:

  • Keep the plaster cast dry.
  • Keep the limb raised, if advised to do so. This lessens the chance of any swelling.
  • Follow advice given about exercising all joints and limbs that are not in the plaster cast, for instance, arms, legs, shoulders, fingers and toes.
  • You will be advised if your child may stand or walk on the plaster cast.
  • Use a cast shoe, if your child has been given one. It protects the plaster and makes it less slippery to walk. Monitor for problems with the plaster cast as explained below. 

Do not:

  • Do not take baths or showers, walk on wet grass or in puddles as it will cause the plaster to disintegrate. The use of waterproof protectors can be discussed with the occupational therapist (OT) or plaster technician.
  • Do not put anything inside the cast. This could irritate the skin and cause an infection.
  • Do not use talcum powder or creams inside the plaster cast. These become gritty when mixed with sweat which could also irritate the skin and cause an allergy or infection.
  • Do not cut or heat the plaster cast. 

Hip spicas

If your child has a hip spica cast, which is like a pair of plaster trousers, you will need to take extra care as follows. 

  • „„Avoid moisture coming into contact with the plaster cast. It will weaken the cast and make it smell.
  • „„If your child is in nappies, change them more often than usual and check them frequently for moisture. Use double nappies to reduce the chance of wetting/ soiling the plaster. Use a small nappy tucked into the nappy area, keeping the plastic folded away from the skin and tuck in around the front, sides and back – remove the plastic tabs to make this easier. Use a larger nappy (big enough to go around the plaster cast) to hold the smaller nappy in place. You will be taught how to do this in hospital.
  • „„It is important your child’s hygiene needs are met while in a hip spica plaster. You can use a flannel, sponge, baby wipes or similar, as long as the plaster itself is kept dry at all times.
  • „„If your child is toilet trained, you will be taught alternative methods of toileting.
  • „„Make sure your child has a balanced diet to avoid constipation. If they become constipated, contact your family doctor (GP), or health visitor for advice.
  • „„To avoid pressure sores it is very important to change your child’s position regularly. You will be taught how to do this, using pillows, cushions, bean bags or similar.
  • „„Do not lift your child by the broomstick bar. You will be shown how to move your child safely. 

Watching for problems with the plaster cast or hip spica

In plaster, your child should not be in significant pain but they may well be uncomfortable.

Please contact the nurse in charge of Sky Ward immediately for advice if:

  • „„Your child’s fingers or toes turn white or blue and feel cold and this does not improve when they/you move their fingers/toes.
  • „„Moving the fingers /toes causes significant pain and/or the cast feels too tight. 
  • „„Their fingers or toes become swollen and do not return to normal when the limb is raised.
  • „„Your child complains of pins and needles, numbness or pain.
  • „„There is oozing or wetness under the cast. 
  • „„The cast starts to smell.
  • „„The cast is rubbing or digging in.
  • „„The position of the plaster slips relative to the limb so that, for example, you can no longer see the fingers or toes. 
  • „„The cast becomes loose, cracks or breaks.
  • „„Your child is distressed and you are unable to calm them as usual. 

You may be advised to see your family doctor (GP) or attend your local hospital. In an emergency, take your child to the nearest Accident and Emergency (A&E) department

Compiled by: 
The Department of Orthopaedic Surgery in collaboration with the Child and Family Information Group.
Last review date: 
January 2014
Ref: 
2013F0524

Disclaimer

Please note this is a generic GOSH information sheet. If you have specific questions about how this relates to your child, please ask your doctor. Please note this information may not necessarily reflect treatment at other hospitals.