Frank Radcliffe Clinic. Plasters and Casts. Information

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1 Frank Radcliffe Clinic Plasters and Casts Information

2 Please Read Carefully Raise the injured leg or arm as much as possible, especially during the first few days. This will help to reduce swelling. Report to the Frank Radcliffe Clinic or Accident & Emergency Department immediately if you have any of the following: Continued swelling to fingers or toes after 24 hours A lot of pain in the limb(s), fingers or toes Blueness in the fingers or toes - not bruising Pins and needles or coldness in fingers or toes Pain, swelling or a hot feeling in the back of the calf muscle (if it is your leg that is affected) Unable to move fingers or toes Any blister-like rubbing or pain under your cast. Any discharge, wetness or smell under your cast Do Not Get your plaster wet - it will disintegrate. Remove any wool/cast padding. Push anything down inside the cast. Walk on your leg plaster cast until you have been advised to do so. Sit close to a fire. Allow the limb to hang down unless it is being used. Cut, heat or otherwise interfere with your cast. Drive with your cast (please discuss this with your insurance company as it may invalidate your insurance) 2

3 If your cast becomes cracked, loose, soft, tight or if you have any concerns, please telephone one of the contact numbers immediately. Before coming to the clinic It is recommended that any prescribed analgesia (pain killers) are taken about an hour before your clinic appointment time. Removal of your plaster Your plaster will be removed using an electric saw with a special blade. The blade is designed so that if it touches the skin it should cause no damage. However, on rare occasions, grazing to the skin may occur. You should be aware of this small risk. Please feel free to ask the staff if you have any queries. Exercises when your arm is in plaster 1. Stretch your fingers and thumb out and spread them apart gently. 2. Make a full fist, getting the fingertips into the palm, and curl the thumb over the fingers. 3. Touch the thumb with the index finger then spread them apart. Repeat with each fingertip. Do 10 of these exercises every 30 minutes. It is important to do these frequently to avoid swelling and stiffness of the hand. 4. Touch the palm of your hand to the same-side shoulder then straighten your arm fully. 3

4 5. Lift your arm above head then lower. 6. Fold your arms across chest then spread them wide. Do exercises 4, 5 and 6 ten times each, 3 times a day. Do not discard the sling until advised to do so. Exercises when your leg is in plaster Lying on the bed or sitting on the floor: 1. Bend and stretch the toes up and down. 2. Push the back of the knee down into the plaster. You should feel the muscles on the front of your leg tightening 3. Raise the leg 6 inches off the bed/floor, hold for 3 seconds, then lower slowly 4. Raise the leg 6 inches, move it out to the side a short distance, then return and lower slowly 5. Squeeze the buttocks together Do not forget when sitting: raise your leg up on pillows or cushions to prevent swelling of the toes take the weight off your bottom frequently Take a short walk, e.g. around the house, every hour. 4

5 Crutches To walk with crutches whilst your leg is in plaster: place both crutches either side of your hip and bend your knee slightly behind you. Move the crutches forward slightly then with your good leg, hop forward slowly into your crutches. Do Take care when going up and down the stairs on your crutches (it may be better to go up and down on your bottom). If you feel you would have difficulty going up or downstairs in your cast, please make clinical staff aware of this. Do not Rush around on your crutches 5

6 Using crutches Standing Place the crutches in the 'H' position with the handles together. Place one hand onto both handles and stand up. Once standing, place each hand through the cuffs of the crutches and hold the handles (handles facing forwards). For stability while standing, each crutch should be slightly in front of and out to the side of your feet. 6

7 Sitting Stand in front of the chair. Take each arm out of the crutches and put them in the 'H' position, holding with one hand. Once balanced, reach back for the arm of the chair with the other hand. In a slow and controlled manner, lower yourself into a sitting position. Walking For non-weight bearing - Keep the injured leg off the ground and, taking the weight with the other leg, place the crutches one step ahead, level with each other. Move forwards between the crutches, swinging the unaffected leg to land just in front of the crutches. For partial weight bearing - Taking some weight with the unaffected leg, place the crutches one step ahead, level with each other. Put the injured leg on the ground, just before the crutches and step through with the unaffected leg. Follow the instructions given by your clinician regarding partial weight bearing. 7

8 Care and maintenance of your crutches Check regularly that: Rubber tips are not worn to the point where no tread is showing Crutches are a matching pair - do not use a mismatched pair Crutches are tight at the elbow and are not cracked Spring clip tips are located in both holes Tubing is not cracked or damaged Adjustment mechanism adjusts freely The holes on the adjustment legs are round and not worn to an oval shape For trough I gutter crutches: Check that the handgrip angle adjustment is tight and the trough attachment bolts are tight Always use the crutches as advised. Once set up for you, there should be no reason to adjust the crutches without checking. Always use the crutches as advised. Avoid wet floors and uneven surfaces. Remove obstacles, such as loose rugs, before using crutches. Do not store in sub-zero temperatures. To use the crutches, wear supportive footwear. Clean metal crutches with mild detergent and warm water. 8

9 Adequate lighting in the home environment is encouraged for safety purposes. Inspect the crutches regularly for signs of wear. If any of the above is a problem contact the department. Ankle fracture What to expect when your cast is removed You may find that after your cast is removed the ankle swells and is more uncomfortable than it has been recently. This is normal and is a consequence of removing the support provided by the plaster. To control swelling you should:- Avoid standing still for any length of time. Sit with your foot up elevated on a chair when you are sitting. Elevation is important to reduce swelling. Use an ice pack wrapped in a damp towel and put it around your ankle for 20 minutes with your foot up. Try to start walking normally again, even if you are still using crutches - with your injured foot allow gentle mobilisation as pain allows. To walk initially put your heel down first and roll over the toes of your injured foot and push off with your big toe (in a rocking movement). 9

10 Below knee walking boots or surgical braces that prevent lower limb movement Please ensure that you follow all instructions including rehabilitation and any activity regime your prescribing clinician has given you. This includes sitting with your foot elevated, removing the boot from time to time and exercising your foot and ankle, rotating your ankles through a 360 degree turn clockwise and then anticlockwise direction 4 times a day. This is important to reduce the risk of Deep Vein Thrombosis. Signs and symptoms of a deep vein thrombosis or a pulmonary embolism While you are in hospital there are certain signs to look out for that could mean you have a blood clot. You should seek medical advice immediately if you experience any of the following in the days or weeks you are in hospital and after your discharge home: You have pain or swelling in your leg. The skin on your leg is hot or discoloured (red, purple or blue), other than bruising around the operation site. Your feet are numb or tingling. The veins near the surface of your legs appear larger than normal or you notice them more. You become short of breath. You feel pain in your chest, back or ribs, which gets worse when you breathe in deeply. You cough up blood. 10

11 If you develop any signs of Deep Vein Thrombosis or think you could have the signs of Deep Vein Thrombosis - please return immediately to the Frank Radcliffe Clinic or your nearest A & E department. Contact Information Frank Radcliffe Clinic Monday to Friday 9.00am 4.30pm Reception or Sister's office A & E Department (out of hours only) 11

12 References Prior, M.A. & Miles, S. 1999, Casting part two. Emergency Nurse, vol.7, no. 3, pp Prior, M.A. & Miles, S. 1999, Principles of casting. Journal of Orthopaedic Nursing, vol.3, pp If you need this information in another format or language, please telephone Further information about the Trust is available on the following websites: KGH - NHS Choices - Ref: PI 102 April 2013 Review: January 2015

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