Information for patients with lower leg immobilisation

PLASTER / SPLINT INSTRUCTIONS:

All patients with a lower limb injury being treated in a plaster cast / backslab / splint should keep the leg elevated and move their toes to encourage blood circulation in the leg and reduce the risk of getting a blood clot (Deep vein thrombosis – DVT).  

Do not take any weight through the leg if instructed to remain ’Non weight bearing’.

Seek help / advice immediately if:

• Your leg looks red, swollen and feels warm and painful.
• Stretching movement of the toes causes severe pain in the leg
• The pain in your injured leg gets worse even after you rest and take medicine.
• Your cast gets wet or damaged.
• Your leg or toes are numb.
• The skin or toes of your injured leg become swollen, cold, or blue.
• Your cast or brace is too tight.
• There are new blood stains or a bad smell coming from under the cast.
• You have new or worsening trouble moving your leg.
• You have questions or concerns about your condition or care.

Cast or splint care:

• Check the skin around your cast and splint daily for any redness or open areas.
• Do not use a sharp or pointed object to scratch your skin under the cast or splint.
• Do not remove your splint unless your doctor says it is okay.

Bathing with a cast or splint:
Do not let your cast or splint get wet. Before bathing, cover the cast or splint with a plastic bag. Tape the bag to your skin above the cast or splint to seal out the water. Keep your leg out of the water in case the bag leaks. Ask when it is okay to take a bath or shower. There are various bespoke plastic water resistant limb covers available on the internet.

Self-care:

• If you have a half plaster (backslab), apply ice on your leg for 15 to 20 minutes every hour or as directed. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel. Ice helps prevent tissue damage and decreases swelling and pain.
• Elevate your leg above the level of your heart as often as you can. This will help decrease swelling and pain. Prop your leg on pillows or blankets to keep it elevated comfortably.
• Use crutches or a walker as directed. Crutches will help you walk and take weight off your injured leg while it heals. Strictly follow the weight bearing instructions given to you in fracture clinic.
• Physiotherapy may be recommended. A physiotherapist teaches you exercises to help improve movement and strength, and to decrease pain and swelling around the injured area.

Follow up with your GP or fracture clinic as directed:

You may need to return to have your splint or cast removed. You may need an x-ray of your leg to check how well the bone has healed. Write down your questions so you remember to ask them during your visits.

Medicines:

• Prescription pain medicine may be given. Ask how to take this medicine safely. You can then carry on with simple pain killers. Always read the medicine label and follow directions.
  Take your medicine as directed. Contact your GP if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbal preparations you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.
• You may be given some blood thinning injections if you are deemed to be at risk of having Deep Vein Thrombosis (DVT). These are self-administered and you will be shown how to do it before you leave the department. You should continue with the full course of anticoagulant injections or tablets if you have been sent home with them. Please remember to discard any needles, safely in the sharps box provided.

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you. 

Feedback
Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: [email protected]

Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.