Serial casting of the legs Home care OTPT (1240)

Key points below

(OT/PT)

What is serial casting?

Serial casting means that casts are put on and then taken off each week. This is done to increase the movement at a joint. Normally, 4 to 6 casts are needed for this to work best.

Important information

Do not get the cast wet.
Your child should not stand, walk or put weight on the cast for at least 2 hours after casting.
Use the cast shoe provided for standing and walking after the cast is dry.

Pay close attention to your child’s foot, especially on the first day.

Look for these signs:

Changes in color of toes or toenails.
Poor circulation or blanching of skin. Blanching means the skin is pale or white. To check for blanching, press on the toes. The pink color should return within 2 to 3 seconds.
Blisters or blood blisters on any part of the toes.

Remove the cast immediately if:

Your child is in pain.
You see swelling that doesn’t go away within 30 minutes after raising your child’s feet.
Your child has severe itchiness that doesn’t go away with ice packs put on the cast.
Your child refuses to put weight on either foot.
There is strange or bad odor coming from the cast.
Your child’s sleep or their personality has changed. This is especially important to watch if your child does not talk.
Changes in the color of your child’s toes or toenails that do not go away after raising your child’s feet.

Removing the cast

Remove the casts at home 24 hours before coming to clinic for re-casting. This will give you time to wash your child’s feet and legs. Take the last cast off in six days. Do not cut the cast off. It will unwrap without using scissors.

Take off the outer layer. Find the end (usually in the back) pull the top piece of the cast, and unwrap.
Take off the hard layer. You may need to loosen the edges with a non-sharp object such as a butter knife and then work it off with your fingers.
Remove the final layer of cast. Find the end and unwrap it.
Take off the cotton padding and sock layer.

ALERT: Call your child’s physical therapist or clinic if you have any questions or concerns or if your child has special health care needs that were not covered by this information.

Physical Therapy Department Children’s Wisconsin (414)266-2858

For more health and wellness information, check out this resource:

https://kidshealth.org/ChildrensWi/en/parents

This sheet was created to help you care for your child or family member. It does not take the place of medical care. Talk with your healthcare provider for diagnosis, treatment and follow-up.

ALERT

Call your child’s doctor, nurse, or clinic if you have any questions or concerns or if your child has special health care needs that were not covered by this information.