Serial casting what to expect (1583)

Key points below

What is serial casting?

Serial casting means that a cast is put on your child’s foot, ankle, and lower leg.  It is changed each week.  Most often, 4 to 6 casts are needed for this to work best. 

Why is serial casting done?leg in cast

To help the joint move better
To help the leg muscles (calves) move better and easier

What happens when the cast is put on?

1. Your child must lie on their stomach with the knee bent.  
2. Their ankle will be stretched. 
3. Your child should be as still as possible while casting. They may read, have a small snack, or watch a video. 
4. The casting materials are put on.  They will be damp.  
5. The cast needs to dry and get hard.  Your child should not stand or put weight on the cast for 2 hours after it is put on.

How do I care for the cast?

We will give you a cast shoe to wear over the cast.  This is to be worn when walking and standing.  It is for outdoor use.
You will also get a grip sock to wear over the cast while walking without a shoe.  This is for indoor use. 
Casts will be on all day and night for 6 days. 
While wearing the casts, your child can do most of their normal, daily activities.  
Do not get the cast wet:
o When showering, cover the cast with plastic bag or waterproof leg casts.  
o For bathing, your child may rest the casted leg outside the tub.    
o Do not swim with casts on. 
o Do not walk in sand, mud, or snow, unless the casts are covered with a waterproof cover. 

Follow up visits

Your child must be able to attend appointments on the same day, once a week, for 4 to 6 weeks. For example, every Monday at 10:00am for 4 to 6 weeks. 
You must remove the cast at home 24 hours before your next casting appointment.  
o Unwrap the cast. Do not use scissors.  
o Throw away the cast in the garbage.  
o Your child may take a full bath or shower.  
o Let the skin that was covered by the cast be open to air. 

What are the next steps after serial casting?

Your child will need outpatient physical therapy sessions. This helps your child learn to walk in a new way.  It will also help:
o make the leg muscles strong 
o your child’s balance
o your child with coordination skills. 
Your physical therapist will explain how often and how long this will take. 

Your child may need to wear new orthotics or leg braces daily.  This keeps the ankle in ideal position.   It will also help your child to walk in a flat-footed pattern. 
Your child may need to wear new night stretching splints.  These are worn nightly while sleeping.  They help keep the calf muscles from getting tight again. This helps them move more easily.
For other health and wellness information, check out this resource:


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