Complications of wearing a cast range from common cast problems to more severe issues which affect the healing of the underlying fracture. Learning about basic cast care – such as how to keep your cast dry and clean – is a good place to start. But what about more serious cast complications, such as itchy skin under a cast, pressure sores under a cast, or severe pain, numbness, and swelling beneath a cast? And when it comes to cast complications, when is it time to call the doctor?
To help make your cast-wearing experience as pain-free and complication-free as possible, here are some common cast problems and solutions:
Itchy Skin Under a Cast
Itchy skin under a cast is very common. However, cast wearers who want to scratch under their cast are in a bind. Sticking objects inside a cast (i.e. a coat hanger or stick) can actually injure the underlying skin and lead to an infection, while using oils or lotions near a cast is also ill-advised. Instead, to relieve itchiness under a cast, the experts recommend the following:
- For red or irritated skin around the edge of a cast, pad the edges with a soft material or cover with tape
- To relieve itchy skin, blow cool air into your cast from a hair dryer or fan
- Apply an icepack wrapped in a thin towel to the closest exposed area
- Invest in a special anti-itch spray, designed to relieve itching, cool skin, and kill odors beneath a cast
Pressure Sores Under a Cast
Another common complication of wearing a cast is the development of pressure sores over bony areas such the elbow or ankle. Pressure sores are the result of sustained pressure on the skin or can be caused by a cast which is poorly fitted or too tight. Symptoms of a pressure sore under a cast include: pain, drainage, a spot on your cast, and odor, which may also indicate a skin infection. If you suspect that you have a pressure sore under your cast, visit your doctor to see if your cast needs to be loosened or replaced.
A much more serious cast complication is called compartment syndrome, wherein swelling occurs within the ‘compartment’ (or space) that houses your broken bones, as well as the muscles, nerves, and blood vessels contained therein. The condition can be caused by a cast that is too tight or by a rigid cast, which creates pressure inside the closed space that cannot be released. The excessive pressure on the nerves, arteries, and veins under your cast causes severe pain, reduces blood flow to the muscles, and can even lead to permanent damage of the tissues if not discovered in time.
Symptoms of compartment syndrome include:
- Cold, pale skin
- Blue-colored skin
- Severe pain
- Numbness or tingling of the affected area
- Difficulty moving fingers, toes or joints of the affected limbs
Compartment syndrome is categorized as a medical emergency and should be treated as soon as possible.
Additional Cast Complications
If you experience any of the following signs and symptoms related to wearing a cast, call your doctor or visit the emergency room:
- Cast feels too tight or too loose
- Skin around the cast is red or raw
- Excessive swelling beneath the cast
- Pain and tightness in the affected limbs
- Burning or stinging under the cast
- Inability to move the fingers/toes of the injured hand or foot
- Cracked cast
- Soft spots in the cast
- Foul odor coming from the cast
Finally, you can avoid many of these and other cast complications with a properly fitted cast protector. By learning to recognize cast problems when they arise and by taking the proper action, you and your injured limbs can look forward to a full recovery.