Caring for Broken Bones
How to use crutches, care for an injury in a cast, and when to call the doctor.
A cast or fixation device may be clunky and inconvenient, but with proper care, it’s often the most effective treatment for a fracture.
You also may need a walking aid, such as crutches or a cane, to get around as you recover. Learning how to use these items and care for your injured bone is important for proper healing.
Casts and slings
These devices help hold your bones in the right position so they heal properly. Follow these general guidelines and your doctor’s recommendations to care for your broken bone as it heals.
An arm sling may be used to support a cast on the hand, wrist, arm or elbow. We recommend wrapping a towel or cloth around the strap to keep the sling from irritating the skin on your neck.
- Bathing: Avoid getting your cast wet. If possible, take a bath instead of a shower. Cover your cast with a sturdy plastic bag secured with a rubber band, or a cast cover you can buy at a drug store or medical supply store. Always check the bag for holes before using it a second time. Hang the covered cast over the side of the bathtub and never lower it into the water.
- If your cast gets wet: You may be able to dry the inside padding with a hairdryer. Use a low, cool setting and blow air down into the cast.
- Itching: If your skin itches underneath the cast, don't slip anything inside the cast to scratch it. You could damage your skin and get an infection. Instead, tap the cast or blow air from a hairdryer on the low, cool setting down into the cast for relief.
- General tips:
- Don’t put anything inside the cast, including powders or lotions -- this can cause infection.
- Leave the rough edges of a plaster cast alone -- if you try to trim or file them down, you may weaken or break the cast.
- You may lose strength or range of motion as your bone heals. If you do, your doctor will work with therapists to design a rehabilitation program that will help you regain strength and flexibility.
Call your doctor right away if you notice any of these symptoms, which can lead to improper healing and other complications:
- The cast gets damaged.
- The cast gets wet. If the skin under the cast is wet for a long period of time, it may become infected.
- Skin or nails below the cast turn blue or gray or become numb, tingling, or cold. This may mean your cast is too tight.
- The cast is loose. This may occur as swelling subsides -- a cast that’s too loose promotes improper healing.
- The cast rubs against or irritates your skin.
- You experience new or increased pain.
- Your limb or cast begins to smell bad. Sweat under the cast can cause mold or mildew to grow.
If the doctor says you can walk on your cast, be sure to wear a cast boot with it. Cast boots have tread to prevent falls and keep the cast from wearing through on the bottom. Do not lean or push on the cast more than is necessary for walking, or the cast may crack.
Walking aids: Crutches, canes, and walkers
It’s important that your walking aid be fitted properly before you leave the hospital or doctor’s office. Prepare your home by removing items that may cause falls, such as area rugs. Extra lighting, non-slip mats, grab bars, and toilet and shower seats also may reduce the risk of falls. You will quickly find that the walking aid ties up the use of your hands. Use a backpack or wear clothing with extra pockets to help carry things.
- Fitting: When you stand upright, the top of your crutches should reach between 1 and 1.5 inches below your armpits. The handgrips should align with the top of your hips.
- Walking: When moving on crutches, your elbows should bend slightly and your hands should absorb the weight. Don't press the top of the crutches into your armpits. Lean forward slightly and put your crutches about one foot ahead of you. Begin your step as if you were going to use the injured foot or leg, but shift your weight to the crutches instead. Your body swings forward between the crutches. Finish the step normally with your non-injured leg. Focus on where you are walking, not on your feet.
- Sitting and standing: Back up to a sturdy chair. Put your injured foot in front of you and both crutches in one hand. Use the other hand to feel for the seat of your chair. Slowly lower yourself into it. Lean your crutches upside down in a handy location -- crutches tend to fall over when standing on their tips. To stand up, scoot to the front of the chair. Hold both crutches in the hand on the side of your good leg. Push yourself up and stand on the good leg.
- Stairs: To walk up and down stairs with crutches, you need to be strong and flexible. We recommend avoiding stairs when possible. If you have to use stairs, take them one step at a time.
- Stairs with handrails: Facing the stairway, hold the handrail with one hand and tuck both crutches under your armpit on the other side. When you're going up, lead with your good foot, keeping the injured foot raised behind you. When you're going down, hold your injured foot up in front, and hop down each stair on your good foot.
- Stairs without handrails: Use the crutches under both arms and hop up or down each step on your good leg -- this takes a lot of strength. An easier way is to sit on the stairs and, using one hand and your good leg for support, scoot up or down each step, holding your injured leg out in front of you and holding your crutches flat against the stairs.
- Fitting: When you stand upright, the top of your cane should reach the bend of your wrist.
- Walking: Your elbow should bend a bit when you hold your cane. Hold the cane in the hand opposite the side that needs support. When you walk, the cane and your injured leg should swing and strike the ground at the same time.
- To walk: Position your cane one small stride ahead and step off on your injured leg. Finish the step with your normal leg.
- To climb stairs: Grasp the handrail and step up on your good leg first, with your cane in the hand opposite the injured leg. Then step up on the injured leg.
- To come down stairs: Put your cane on the step first, then your injured leg, then your good leg. The good leg should carry your body weight.
- Fitting: A walker with four solid prongs provides the most stability and allows you to shift weight off of your lower body. When you stand upright, the top of your walker should reach the bend of your wrist.
- Walking: Take your time as you learn to use your walker.
- To walk: Put your walker one step ahead of you, making sure the legs of your walker are level to the ground. With both hands, grip the top of the walker for support. Step off with your injured leg and move into the walker, but not all the way to the front bar. Touch the heel of the foot of your injured leg to the ground first, then flatten the foot. Lift your toes off the ground as you complete the step with your good leg. Take small steps when you turn to avoid falls.
- To sit and stand: Back up until your legs touch the chair. Reach back to feel the seat, and lower yourself into the chair. To stand, push yourself up and grasp the walker's grips.
- General tips: Make sure the rubber tips on your walker's legs stay in good shape -- this helps avoid slipping. Never try to climb stairs or use an escalator with your walker.