Leg foot casts aug 2017

Podiatric Surgery

Leg / Foot Casts (Plaster and Acrylic) Introduction

As part of your treatment you will be placed into a below-knee cast.

This is usually after an operation to fuse several foot bones surgically or to give your foot a period of weight relief with immobilisation to allow healing to occur. Plaster of Paris is used after surgery and acrylic is used in the outpatient clinic as a lightweight cast for longer periods.

This leaflet is to provide information on how to look after your cast.

Post-operative cast care After the operation you will be placed into a plaster of Paris cast which is initially heavy and very warm due to the plaster setting. Part of your foot may still be numb and you will need to keep a close eye on the colour of your toes.

They should be bright pink and warm and should not be blue. If you are concerned about the colour of your toes you should tell your doctor or nurse. Post-operative casts are usually fairly loose to allow some swelling and bleeding to occur without restriction.

Weight bearing Your cast is a non-weight bearing cast so please do not put the casted foot on the floor or step on it. Weight bearing casts are different in design with a built-in heel. Getting around the house and living a normal life will be difficult but please do persevere.

Day vice

Crutches Please use the crutches you were given to mobilise around the house. Be careful not to slip or hurt your shoulder joints.

Showering Please keep the cast dry at all times. Small spills can be dried with a hair dryer. If you attempt to bathe or shower you will probably get it wet and it will need to be replaced. This might entail a long wait at hospital. It is better to strip wash for a short time and allow the cast to do its job undisturbed. Proprietary waterproof cast bags are available which do work well. These can usually be bought from medical supply shops.

Cleanliness If your toes are easily visible you may clean between the toes with baby wipes. Be careful not to disturb the cast padding or surgical dressings.

Circulation Your toes should remain a healthy pink colour and be warm. Any increasing calf pain with blueness of the toes needs to be reported immediately. A feeling of tightness can be relieved by elevating the leg.

1 PFS-2395-1730-01

Leg / Foot Casts (Plaster and Acrylic) Sensation This should return to normal after a day or so following surgery. Some operations are performed with injections behind the back of the knee, in which case the foot and leg may be numb for up to two days. You will be advised of this.

Movement After a week or so you may notice the cast is a little looser. This is normal and is due to a small degree of muscle wasting. Muscle wasting is fully reversible and seldom a problem.

Itching This is a well-known problem which some people believe can be solved by scratching under the cast with a knitting needle. Although initially helpful, it will cause rucking-up of the cast padding which was applied in a fashion to avoid the build-up of pressure areas. Any interference with this will cause further problems, so please try to resist the urge to scratch any itches under the cast!

Cast claustrophobia Some people find wearing a cast unbearably restrictive. After your surgery is not the best time to discover this. This feeling is understandable but you do need to persist. Try to accept the restrictions of your cast, however unpleasant this may be. It will get better in time.

Solving cast problems The top and end of a plaster cast can sometimes soften. This is not a concern.

Itching can be relieved by gently moving the leg within the cast and taking painkillers.

Mild swelling is best dealt with by elevating the leg above hip level.

Blood clots in the leg (DVT) is an unfortunate and uncommon problem. It can occur more often after surgery if you smoke or are on the pill or hormone replacement therapy (HRT). Patients who are thought to be at higher risk will have been advised about this and may require blood thinning injections.

You are advised not to fly while wearing the cast, or for two weeks following its removal.

Do not drive. If your left leg is casted and you have an automatic car, check with your insurance company for advice.

When the cast is removed the leg is likely to be hairy and dry. Don’t worry! This will improve with bathing and moisturising.

Day vice

The leg may have lost some muscle bulk. This will take several weeks to resolve. Once the cast is removed, please don’t expect to return to normal activity immediately. It may take some time.

Useful numbers

Braintree Community Hospital

Podiatric Day Surgery Unit

01376 555 900

01376 555 908

If you have any concerns during the first 24 hours following your discharge from hospital, please telephone the ward you were on. After 24 hours, please seek advice from your GP. This document can be made available in other languages and formats upon request.

Podiatric Surgery at Braintree Community Hospital, April 2015. Review due: July 2019

2 PFS-2395-1730-01