Why splints and casts?

Splints and casts support and protect injured bones and soft tissue, reducing pain, swelling, and muscle spasm. In some cases, splints and casts are applied following surgery.

Splints or "half casts" are usually applied immediately following surgery or injury because they accommodate swelling from injuries and surgery easier than enclosed casts.

Types of Splints and Casts

Casts are custom-made and can be made of plaster or fiberglass. Splints or half casts also can be custom-made, especially if an exact fit is necessary. Other times, a ready-made splint will be used. These off-the-shelf splints are made in a variety of shapes and sizes, and are much easier and faster to use. They have Velcro straps which make the splints easy to adjust, and to put on and take off.

What materials are used in splints and casts?

Fiberglass or plaster materials form the hard supportive layer in splints and casts. Fiberglass is lighter in weight, longer wearing, and "breathes" better than plaster. Plaster is less expensive than fiberglass and for some uses shapes better than fiberglass. Both materials come in strips or rolls which are dipped in water and applied over a layer of cotton or synthetic padding covering the injured area.

How are splints and casts applied?

Both fiberglass and plaster splints and casts use padding; usually cotton, as a protective layer next to the skin. The splint or cast must fit the shape of the injured arm correctly to provide the best possible support. Frequently, a splint is applied to a fresh injury first and, as swelling subsides; a full cast may be used to replace the splint. Sometimes, it may be necessary to replace a cast as swelling decreases and the cast "gets too big." Often as a fracture heals, a splint may be applied again to allow easy removal for therapy.

Getting use to the splint or cast

• Swelling due to your injury or surgery may cause pressure in your splint or cast. This may cause your injured hand, wrist, elbow or arm to feel too snug or tight in the splint or cast. To reduce the swelling:

1. Elevate your injured arm above your heart by propping it up on pillows or some other support. Elevation allows clear fluid and blood to drain "downhill" to your heart.    
    
2.  Following an injury or surgery the tendency will be not to want to move the uninjured or     unoperated parts of the extremity. IT IS VERY IMPORTANT TO KEEP THOSE JOINTS THAT ARE NOT IN THE SPLINT OR CAST MOVING SO THEY DON'T GET STIFF. Every two hours while awake, do this four times:
         A.  Within your splint or cast, try to make a strong fist, and then try to fully straighten your fingers (unless you had one of your fingers or thumb injured or operated on then don't move the injured or operated digit unless you have been instructed to).
        B.  Fully bend and straighten out your elbow (unless you had your elbow injured or operated on).
        C.  Raise your arm straight above your head (as though you were trying to touch the ceiling) then put both arms behind your back and trj to touch your shoulder blades with both your thumbs (this exercise will help keep your shoulders from getting stiff).
    
3. During the first 24 hours after your injury or surgery you may apply ice to the splint or cast. Place the ice in a dry plastic bag or ice pack and loosely wrap it around the splint or cast at the level of the injury.

Warning Signs Following Splint or Cast Application

After application of a splint or cast, it is very important to elevate your injured or operated on arm. For at least the flrst week, keep your hand up as much as possible - day and night. If your elbow is injured or was operated on try to keep your elbow elevated as much as possible. You do not need to wear a sling unless it helps you keep your hand or elbow elevated. The injured area should be elevated well above the heart. Elevation greatly reduces pain and speed the healing process by minimizing early swelling. If you experience any of the following warning signs, contact me immediately:

• Increased pain, which may be caused by swelling, and the feeling that the splint or cast is too tight.
• Numbness and tingling in your hand or foot, which may be caused by too much pressure on the nerves.
• Burning and stinging, which may be caused by too much pressure on the skin.
• Excessive swelling below the cast, which may mean the cast is slowing your blood circulation.
• Loss of active movement of your fingers.

Taking Care of Your Splint or Cast
After you have adjusted to your splint or cast for a few days, it is important to keep it in good condition. This will help your recovery.

•  Keep your splint or cast dry. Be careful, the padding beneath the cast surface is not water repellent. Keep your cast as dry as possible to prevent skin irritation and odor. The inside of the cast should be dried with a hair drier (cool setting) in the morning, evening, after bathing or exercise, and additionally as often as you like - this will help prevent itching and reduce skin irritation.
• When bathing or showering cover your splint or cast with a plastic bag (or saran wrap, in a pinch). Hold your hand up in the shower so that water does not run down inside the splint or cast. If your cast does get wet, towel blot the cast, then use a blow dryer (cool setting) until it is completely dry. If this does not work contact my office.
• Do not trim or re-shape your splint or cast. The splint or cast has been custom designed to provide maximum support during healing. Cutting or altering the splint or cast may lengthen your recovery time. If the padding has shifted and the edge of the splint or cast rubs against your skin, you may be able to pad it with moleskin (available in the foot care section of any drugstore). However. if the splint or cast feels as though it is tight or is irritating your skin, please contact my office. I may have to modify or even change your splint or cast, but would rather do that than for you to have a problem.
• Almost every splint or cast itches at some time, but never insert anything under your splint or cast to scratch an itch _ you could cause severe skin injury. A void getting dirt or other foreign particles under your splint or cast. Don't put talcum powder or com starch inside the splint or cast - these may start a skin infection. The best treatment is to dry the inside of the splint or cast with a hair drier (cool setting).
• Inspect the skin around the cast. If your skin becomes red or raw around the splint or cast contact my office.

Proper Cast Removal

Never remove your splint or cast yourself.  You may cut your skin or prevent proper healing of your injury. We will use bandage scissors to remove your splint. If you have a cast we will use a cast saw to remove your cast. The saw vibrates, but does not rotate. If the blade of the saw touches the padding inside the hard shell of the cast, the padding will vibrate with the blade and will protect your skin. Cast saws make noise and may feel "hot" from friction, but will not harm you - their "bark is worse than their bite."

Use common sense. You have a serious injury and you must protect your splint or cast from damage so it can protect your injury while it heals. After initial swelling has subsided, proper splint or cast support will usually allow you to continue your daily activities with a minimum of inconvenience.

IF YOU HAVE ANY QUESTIONS, CONCERNS OR PROBLEMS REGARDING YOUR SPLINT OR CAST PLEASE DO NOT HESITATE TO CALL ME.