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Getting a Cast for a Fracture: Types, Care, Complications

A boy sits on the couch next to an older man with his casted leg and foot elevated.

A fracture can be a painful injury that takes weeks or months to heal. It is important to get a bone break evaluated and treated right away to avoid long recovery times, additional pain, and other complications. A cast for a fracture is the most common method of treatment.

What Is a Fracture?

‘Fracture’ is another term for a broken bone. Causes of fractures include physical trauma, overuse, repetitive movements, and bone-weakening diseases like osteoporosis. A fracture can be obvious and acute or more subtle, occurring over a period of time.

The primary symptom of a fracture is pain, but swelling, bruising, and a visible deformity can also occur. Different types of bone fracture include:

A patient sitting on an exam table with her leg in a cast talks to a doctor sitting next to her.

  • Stable fracture: The bone remains properly aligned.
  • Open fracture or compound fracture: The skin has been pierced and the bone may or may not be visible.
  • Transverse fracture: The break is horizontal.
  • Oblique fracture: The break is at an angle.
  • Comminuted fracture: The bone breaks into three or more pieces.

Treating Fractures

The type of treatment a doctor recommends for a fracture depends on the fracture type and severity. Cast treatment for a fracture is the most common option. You might also need traction, which realigns the bone around the break.

A cast is a device used to support healing by surrounding and immobilizing the area of the fracture. This holds the broken bone in the correct position so it can heal correctly. It speeds healing and prevents additional injuries to the area.

More complicated breaks sometimes require surgery to realign the bones and fix them in place with screws, pins, or plates.

Complications of an Untreated Fracture

A woman sits next to a boy in a hospital bed as they draw on his cast.

It is important to get treatment for a fracture right away, even if it doesn’t seem serious. Bones naturally begin to heal immediately after a fracture, so if they need manipulation or realignment, it should be done quickly.

Without proper treatment, the fracture will take longer to heal or will heal incompletely or in the wrong position. Other potential complications include nerve damage, ligament or muscle damage, and ongoing pain and inflammation.

Types of Casting

The primary cast types for fractures use two different kinds of material:

Plaster Cast

This was once the most common type of cast. To create it, doctors wrap the affected area of the body with a special type of fabric. Over this, they apply a thick paste called plaster. The plaster hardens over the fabric to create a hard, protective cast.

Plaster isn’t used as often today as it once was, but there are some benefits. It is inexpensive compared to a synthetic cast. Plaster is also easier to mold around the shape of the body, so doctors may choose it for a difficult area. On the other hand, plaster casts require more care and are heavy.

Synthetic Cast

More commonly used now is a synthetic cast, typically made of fiberglass. As with plaster casts, doctors begin by wrapping the affected area. They then apply several layers of soaked fiberglass. This can be molded over the area but not as easily as plaster. Fiberglass casts harden within a few hours.

A fiberglass cast is more porous, which allows doctors to take X-rays of the bone without removing it. This characteristic also makes fiberglass lighter, more breathable, and generally more comfortable to wear.

Splint vs Cast

A splint is similar to a cast; its goal is also to immobilize and protect an area of the body to allow a fracture to heal. Also known as a half-cast, a splint is less supportive. It provides some stability to the injured area and is quick to apply and remove.

Splinting is faster and easier than casting, which is why it is the preferred method of immobilization for acute and emergency care. The idea is to stabilize a fracture quickly and then refer the patient for long-term treatment.

A splint can be the definitive treatment for some fractures that are simple and do not require complete immobilization. The benefit of a splint is that it’s easy to remove and adjust to accommodate swelling. For more complicated and unstable fractures, a cast remains the preferred treatment.

How to Take Care of Your Cast

If you need a cast to treat a fracture, your specialist will describe how to take care of it and what you can and cannot do with it. Follow instructions for the best results.

Keeping the cast dry is important. You must wrap it securely in plastic to bathe or shower. You might be able to get a waterproof synthetic cast, but these are not common. You should also keep the cast clean both inside and out. If you’ll be doing something messy, wrap it in plastic.

Avoid attempting any adjustments on your own. If the cast is uncomfortable, too tight, or causes swelling, see your doctor.

Potential Complications of Casting

Casting is generally safe and often necessary to treat a fracture, but there are potential complications too, such as:

  • Compartment syndrome
  • Skin breakdown
  • Fungal or bacterial infections
  • Joint stiffness
  • Itchy skin

Contact your doctor immediately if you experience increased pain and tightness in the cast, numbness, burning, stinging, excessive swelling below the cast, or loss of sensation or movement in fingers or toes. 

A fracture can be a painful, debilitating injury, but a cast is an effective and efficient treatment method that speeds recovery. If you have an injury that may require treatment, contact SI Ortho to schedule an appointment or stop by one of our urgent care locations.