Whether you’ve fractured your wrist, forearm, or hand, proper cast care is essential for a smooth recovery. At Raleigh Wrist, our orthopedic specialists provide expert upper extremity casting and fracture management to patients throughout the Raleigh, NC area — helping you heal safely and get back to the activities you love.

What Is Upper Extremity Casting?

A cast is a circumferential immobilization device made from plaster or fiberglass that holds broken bones in proper alignment while they heal. Upper extremity casts are used to treat fractures and certain soft tissue injuries of the wrist, forearm, hand, and elbow. Casts provide superior immobilization compared to splints and are typically used for definitive fracture management once initial swelling has subsided.

Common Conditions Treated with Upper Extremity Casts

– Distal radius fractures (broken wrist) — the most common forearm fracture in adults, often caused by a fall onto an outstretched hand

– Scaphoid fractures — a common carpal bone fracture requiring a thumb spica cast

– Forearm fractures — including ulna (nightstick) fractures and combined radius-ulna fractures

– Metacarpal fractures — fractures of the hand bones

– Pediatric wrist and forearm fractures — including buckle (torus) and greenstick fractures

– Post-surgical immobilization — following wrist or hand surgery

Types of Casts and Splints We Use

– Short-arm cast — extends from below the elbow to the hand; used for stable wrist and distal forearm fractures

– Long-arm cast — extends from the upper arm to the hand, immobilizing the elbow; used for more unstable forearm fractures

– Thumb spica cast — includes the thumb for scaphoid and certain thumb injuries

– Sugar-tong splint — a U-shaped splint used for initial management of wrist fractures before transitioning to a cast

– Custom removable orthoses — for select stable fractures where removable immobilization is appropriate

How Long Will I Wear a Cast?

The duration of immobilization depends on the type and severity of the injury:

– Distal radius fractures (adults):  6 weeks

– Buckle fractures (children): approximately 3-4 weeks

– Scaphoid fractures: 6 to 12 weeks depending on healing

Your Wrist specialist will monitor healing with follow-up X-rays and adjust your treatment plan as needed.

Cast Care Instructions

Proper care of your cast is critical to avoid complications and ensure optimal healing:

Keep Your Cast Dry

Moisture weakens plaster casts and can cause skin irritation or infection beneath the cast. Cover your cast with a plastic bag when showering or bathing. If your cast gets wet, contact our office.

Elevate Your Arm

Keep your hand and wrist elevated above the level of your heart, especially during the first 48 to 72 hours. This reduces swelling and helps manage pain.

Move Your Fingers

Gently wiggle and bend your fingers regularly to maintain circulation and prevent stiffness. Finger exercises are encouraged throughout the healing process.

Do Not Insert Objects Into the Cast

Never push objects inside the cast to scratch itchy skin. This can cause skin breakdown, infection, or shift the padding. For persistent itching, try a hair dryer on a cool setting directed into the cast opening.

Watch for Warning Signs

Contact Dr. Chambers  or seek immediate medical attention if you experience:

– Increasing pain not relieved by elevation or prescribed medication

– Numbness, tingling, or loss of feeling in your fingers

– Fingers turning blue, white, or feeling cold

– Increased swelling above or below the cast

– A foul smell or drainage from the cast

– A cracked, broken, or loose-fitting cast

These symptoms may indicate complications such as compartment syndrome, pressure sores, or vascular compromise — all of which require prompt evaluation.

Potential Complications of Casting

While casting is a safe and effective treatment, complications can occur and include:

– Skin irritation and pressure sores — from poorly fitted or wet casts

– Joint stiffness — temporary stiffness is common after cast removal

– Muscle atrophy — mild weakening of muscles during immobilization

– Compartment syndrome — a rare but serious condition caused by excessive pressure within the limb

– Complex regional pain syndrome (CRPS) — an uncommon chronic pain condition that can develop after injury and immobilization

At Raleigh Wrist, our team carefully monitors every patient throughout the casting period to minimize these risks.

What Happens After Cast Removal?

Once your cast is removed, some stiffness and weakness are normal. Your Raleigh Wrist provider may recommend:

– A home exercise program to restore range of motion and strength

– Physical or occupational therapy for more complex injuries

– A removable brace or splint for additional protection during the transition period

– Follow-up imaging to confirm complete healing

Why Choose Raleigh Wrist for Your Upper Extremity Cast Care?

– Specialized expertise in wrist, hand, and forearm injuries

– Evidence-based treatment protocols tailored to each patient’s injury

– Comprehensive care from initial evaluation through full recovery

– Convenient Raleigh location serving patients across Wake County and the Triangle area

– Advanced immobilization options including traditional casts, fiberglass casts, and removable orthoses

Schedule Your Appointment in Raleigh

If you’ve suffered a wrist fracture, forearm injury, or hand injury, don’t wait. Contact Raleigh Wrist today to schedule an evaluation with one of our upper extremity specialists. Early, expert treatment leads to better outcomes and a faster return to your daily life.

Stephen Chambers, MD — Expert Wrist and Upper Extremity Care in Raleigh, NC