To avoid problems, the cast must be kept clean and dry. Nothing should be placed inside the cast to scratch an itchy patch of skin. Keeping a cast clean and dry requires wrapping a towel and plastic wrap or a plastic bag around all openings during bath time. Baths are preferred to showers since it’s easier to protect the cast from water during a bath. Have your child rest the injured arm or leg on the ledge of the bathtub to keep it dry, and be sure not to submerge the cast in the water. Cast covers are available for purchase; however, they don’t always work. The only way to guarantee a cast stays dry is to wrap it securely and keep it out of all water.
Should your child’s cast get wet, call your orthopedic office immediately. The staff will get you in and replace the cast with a new one once the skin has dried. If this happens after hours or on the weekend, staff at one of CHKD’s urgent care centers or the emergency department can remove your child’s wet cast and replace it with a splint. You should then call your orthopedic office to schedule an appointment for a replacement cast.
If there is any doubt about whether your child’s cast is wet, call the orthopedic office to schedule an appointment. Its always better to be safe than sorry. Making an extra trip to the doctor or urgent care is not ideal, but the risks of staying in a wet cast are far too great. If its not taken care of, you and your child could be dealing with “a fungus among us!”
If your child’s cast gets wet, the cotton lining will stay wet. This poses several problems. A wet cast will begin to smell moldy, and the dampness inside can cause a breakdown of the skin called maceration. Just as your fingers and toes turn wrinkly after being in the bath or a pool, having a wet cast on for too long will cause the same thing to happen. Extreme skin maceration can lead to an infection and possibly require surgery to clean the damaged tissue. If your child’s fracture required an open surgical procedure, such as a pinning, keeping the cast dry is every more important. The risk of infection increases tremendously due to the open wound from the surgical procedure.
Casts nowadays are made of fibreglass and are much lighter and more water resistant than plaster casts. However they must still be kept dry and to save wearing out at extremities, owners are often advised to tape a piece of inner type tube or rubber onto the ends that are continually being abraded (it also provides water proofing for going outside). A “wetsuiting style” stubbie cooler also often works well.
Casts are not indestructible ‑ and the animal should be kept relatively quiet to preserve the cast and allow wounds and fractures to heal. Too much movement can lead to rubbing of the skin at the top of casts causing redness and inflammation. Should this happen, line the top of the cast with elastoplast or tuck cotton wool in around the top of the cast and see your veterinarian if the problem persists. Animals with a cast on must normally be in a small pen (toilet or ensuite sized) or on a 2-3metre chain. They may be walked a short distance ON A LEAD for toileting.
Drains are sometimes stitched into wounds to help rid the wounds of excessive fluids and discharge. Pets may tend to pull, lick and chew them out so that an elizabethan collar or bucket may have to be worn when you are unable to watch them (usually of a night or through the day if you leave them to go to work).
Casts are often used for leg fractures and applied for up to 6-8 weeks. The length of time depends on the type of fracture and age of the animal. Each day casts should be checked for signs of irritation (e.g. unpleasant smells, animals chewing at cast due to pain underneath). Smelling allows early detection of pressure sores, wound problems etc. Placing a finger up between the toes allows you to check the toes are warm with normal circulation.
Some animals will go home with bandages over wounds or on limbs. You must try to keep the bandages dry. If they do get wet its best to ring and check if the vet wants to replace them. Most bandages are changed every 2 to 3 days (but sooner if they get wet). If animals tend to chew or tear at bandages a special collar or “bucket” may have to be fitted over his/her head. When going outside to the toilet, a plastic bag wrapped around the bandage is helpful to keep bandages clean and dry. A “wetsuiting style” stubbie cooler can also work well.
Efficacy of Casting and Splinting in Dogs
Surgically treated fractures will heal approximately 97% of the time without complications of serious nature. The rate of healing can be as low as 50% to 95% depending on whether or not the canine is experiencing secondary complications (swelling, infection). Casting and splinting conducted by a veterinary or orthopedic veterinary profession will result in permanent fixation of the affected skeleton.