What should you know about mitten cast for fracture?

This cast usually surrounds the forearm, wrist and hand, with the fingers extending beyond its edge. The design can help hold a fracture in the intended position while allowing the care team to see finger colour, swelling and motion. A clinician may use plaster of Paris or fibreglass cast material, depending on the injury and the stage of treatment. A cast may follow closed reduction, when the bone is gently realigned without an incision. The exact shape and length depend on the fracture, swelling and joints that need support.

Keep the cast dry and do not insert objects underneath it to scratch. Rest the arm as instructed and elevate it when swelling is present. Move the exposed fingers gently and regularly unless your clinician has restricted movement. Check the skin around the cast for rubbing, pressure or new drainage. Do not trim, loosen or repair the cast yourself. Follow the review plan so the fit can be checked as swelling changes and healing progresses. Later rehabilitation may help restore wrist, hand and finger strength and movement.

Seek prompt medical help for increasing pain or tightness, numbness, tingling, inability to move the fingers, or fingers that become pale, blue or unusually cold. Contact the treating service if the cast cracks, becomes wet, develops a sharp edge, smells bad or causes a persistent pressure spot. Sudden worsening swelling or pain after a new injury also needs assessment rather than home adjustment.

Ask which fingers and joints you may move, how to protect the cast during washing, when it will be reviewed, and which symptoms mean you should return immediately. Ask whether your injury is being managed with fracture casting or whether closed reduction or fracture fixation surgery may be considered.