Usually complete healing takes between 6-8 weeks, depending on the bone and any other associated injuries.
2) What are the cast or splints doing for me?
They restrict movement around the broken bones (fracture) to keep the bones from moving so they can heal properly. For a finger fracture, sometimes a simple “buddy strap” or splint is all that is needed to restrict movement of injured areas. If a fracture involves the mid section of the hand or thumb, this area will need to be protected. When the wrist is broken, the cast will extend from the palm of hand to about mid forearm. If a bone in the elbow is fractured, a “hinged” type of splint is often used which allows a stable, but restricted, amount of motion while bones heal. If the shoulder is fractured, a splint (Sarmiento brace) or sling is often used to reduce motion while healing occurs.
This can vary according to what bone is fractured, whether you had to have surgery, and how well your body can heal. If you have had an open reduction with internal fixation (ORIF) surgery using metal plates, this acts like an internal cast and you only need a splint or cast for 2-3 weeks. If you did not have surgery, then a cast or splint is needed to provide external support for healing – you will need to wear this at least 4 weeks (and sometimes longer). Sometimes you can transition from a cast (very restrictive) to a splint (less restrictive) as healing progresses.
Yes and no. It depends on where the fractured bone is located. We usually recommend that you continue to move the joints above and below the fracture that are not being limited by the cast or splint. For example, if a finger is injured, we would recommend you keep moving all the other parts of your arm, including your other fingers. If you are wearing a cast made to protect your wrist, it is very important to keep moving your fingers and elbow. Also, it is important to shrug your shoulders and continue to use your arm for simple, light tasks like getting dressed, brushing hair or eating.
5) After I get the cast/splint removed, is it safe to use it like normal?
Usually the cast/splint is removed before the bones are able to accept full weight bearing or heavy loads. Also, the soft tissues (muscles, tendons and ligaments) have often become shorter and weaker. You will need to work on lengthening the muscle and tendons with stretches for the first 3-4 weeks. Then, the muscles will need time to rebuild their power – this can begin around 8 weeks after the injury. But yes, it is safe to use the arm for simple self care tasks, writing/typing and light aerobic exercise.
Mild swelling of the injured part is normal, but if the cast is applied while swelling is getting worse, it may make the cast too tight. If the tight cast causes fingers to feel numb or turn blue, the cast must be loosened or replaced as soon as possible. If you smell foul odor, this may indicate an infection and you need to see the doctor. If your cast breaks, cracks, or becomes loose, let your doctor know immediately. Apply an ice bag and keep your hand or arm elevated the first few days to help reduce swelling and pain. Do not get cast wet. Wrap the cast in plastic when bathing. Move your fingers every day to help prevent stiffness and swelling.
Traditional casts can be heavy, inconvenient, stinky and limit starting rehabilitation, which can greatly delay your return to normal life . Often times after a upper extremity fracture, a cast can be transitioned to a custom splint.
Can adjust week to week to adapt to your healing and function
Able to take on/off for activities like showering
Allows proper timing to start rehabilitation, so you can return to normal life faster
Doesn’t Damage Skin
Dr. Rachel Lorch is an American certified Occupation Therapist and Hand Specialist at UP Clinic. A hand specialist can make custom splints and adjust prefabricated splints. They can provide you with an expert evaluation and assess bone healing. Transitioning from cast to splint requires adequate bone healing. Our team of doctors can evaluate when it is time to remove your cast and transition you to a custom splint. They will also create a personal rehabilitation program specific to your goals and needs.