Waterproof casts- It’s Summer and I have a wrist or thumb fracture
Jacki Shannon - AHTA Accredited Hand Therapist
Casts provide excellent immobilisation for stable fractures. A circumferential cast can be applied once the swelling has reduced, usually about ten days after a fracture. You would normally be fitted with a backslab in the hospital accident and emergency or at your local hand therapy clinic immediately after a fracture and this is worn until you are reviewed by your practitioner of hand therapy and a circumferential cast is applied.
The waterproof effect is obtained via the lining of the cast. The lining is a synthetic, water resistant material that allows water to drain from the cast so you can shower and swim like normal. The cast itself can be either fibreglass or polyester and it is also water resistant. These casts like to be cleaned! A normal shower or bath is an excellent way to clean the cast. Gone are the days of the white plaster of paris cast and the plastic bag for showering. Waterproof casting is a great option for both children and adults.
Some fractures can be managed with a removable splint/orthoses and this can also work very well. If you know you might remove your splint/orthoses too often or have to keep working more than you should a cast can be the best option. If your track record with compliance is not good then a cast is a great option for you.
Your local practitioner of hand therapy will be able to fit a comfortable waterproof cast for you and discuss the do’s and dont’s of cast management.
It’s important to keep the shoulder, elbow and fingers and thumb moving with regular exercises to avoid stiffness of the non injured areas.
It is also important to ensure you avoid getting sand / dirt down the cast as it can be irritating and hard to shift. Ensure you rinse the cast very well with tap water after swimming. Also never stick things down your cast as it can irritate the skin or squash the lining and make the cast uncomfortable.
If you experience pins and needles or numbness this can mean your cast is too tight, sometimes this can be alleviated with elevation and slowing down your activities. If these symptoms are not improved with these measures the cast may need to be reviewed by your practitioner of hand therapy for it to be split.
If you need to fly it is advisable to collect a medical certificate confirming you are fit to fly with a cast. This is best discussed at a fracture clinic or in the rooms of your treating doctor. Some airlines will not allow you to fly in the first 48hours after a circumferential cast has been fitted. You should also contact your airline to check their policy regarding casts and flying.
Contact your local practitioner in hand therapy today to discuss the benefits of waterproof casting and get your summer mojo back!