Broken leg in plaster: care and warning signs

Keep the plaster dry, avoid putting objects inside it and follow the weight-bearing instructions given by your fracture team. The cast may feel snug when swelling is present, but it should not cause worsening pain, numbness or colour change in the toes.

Plaster is moulded around padding to limit movement and keep the broken bone in an acceptable position. Some fractures are aligned with closed reduction before the cast is applied. The cast may later be changed as swelling settles or healing progresses.

A clinician decides whether you may place weight through the injured leg. That decision depends on the fracture pattern, its position and the treatment plan, not simply on how comfortable the leg feels. Follow-up imaging may be used to check that alignment is maintained.

Elevate the leg as advised, gently move exposed toes, and use crutches or another aid exactly as taught. Protect the plaster from water during washing. Do not trim it, remove padding, walk on it unless permitted, or use powders and sharp objects beneath it.

Check the skin at the cast edges and look at the toes each day. A crack, soft patch, unpleasant smell, wet padding or a cast that becomes loose should be reported to the treating service. Take prescribed pain relief as directed and attend each cast and fracture review.

Seek urgent assessment if pain is severe or rapidly worsening despite elevation and prescribed medicine, or if the cast feels increasingly tight. New numbness, persistent pins and needles, inability to move the toes, or toes that become pale, blue, cold or markedly swollen can signal pressure on nerves or circulation.

Prompt care is also needed for fever with increasing pain, fluid or a foul smell from beneath the cast, a cast that becomes soaked or badly damaged, chest pain, sudden breathlessness, or new painful swelling above the cast. Do not try to split or remove the plaster yourself.

Confirm whether any weight may go through the leg, which walking aid is suitable, and how to keep the cast dry. Ask when the next examination or image is planned, how long immobilisation may be needed, and what movement is safe for the knee, toes and uninjured joints.

Before cast removal, discuss what stiffness and weakness to expect and whether physiotherapy is appropriate. If work, driving, travel or home access is difficult, ask for advice tailored to your fracture and mobility restrictions.