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Sprains are injuries to the ligaments that hold bones in a joint together. They can range from mild stretching of the ligament to a complete tear or rupture of the soft tissue. Depending on the severity of the sprain, it may be necessary to immobilize the joint in a cast to allow it to heal properly. This is especially true if slight movement of the injured ligaments causes pain, permanent changes to joint function, or an inability to bear weight. Casts are custom-made to fit the shape of the injured limb and are typically made of plaster or fiberglass. They are usually worn for 3-8 weeks, depending on the severity of the injury.
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| Characteristics | Values |
|---|---|
| When to use a cast | When the sprain is severe and causes pain, changes to wrist function, or an inability to bear weight on the joint. |
| When to use a splint | When the sprain is mild and can be managed with over-the-counter pain medications and home care measures. |
| Cast material | Plaster or fibreglass. |
| Splint material | Cloth, foam, plaster or fibreglass. |
| Cast application process | Takes a few hours to apply a fibreglass cast. Plaster casts can take up to two days to completely harden. |
| Cast removal process | A doctor will use a cast saw to remove the cast. |
| Cast risks | Pressure sores, compartment syndrome, deep vein thrombosis (DVT), and infections. |
| Cast care | Elevate the cast, ice it to prevent swelling, and avoid getting it wet. |
| Cast duration | Typically 3-4 weeks, but can be up to 8 weeks for more severe sprains. |
| Splint duration | Until the injury has healed. |
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What You'll Learn
When to use a splint vs a cast
Splints and casts are commonly used to support bones and joints while they heal from injuries. They are often used for similar purposes, but there are some key differences.
A splint is a removable device that temporarily immobilizes a joint after an injury. Splints are usually made of softer materials like cloth or foam, and they can be removed and reapplied as needed. They are also lighter than casts, and can be adjusted to accommodate changes in swelling. They are faster and easier to apply, and can be purchased from pharmacies or medical supply stores. They can also be used to increase motion in a stiff joint.
Casts, on the other hand, are devices used to keep a broken bone from moving and to protect it from further injury. They generally provide more effective immobilization, but they require more skill and time to apply and have a higher risk of complications if not applied properly. They also have to be cut off with a cast saw for removal. They are typically made of plaster or fiberglass, and have to be applied by a healthcare professional.
The type of splint or cast used will depend on the location and severity of the injury. For example, a splint may be worn for several weeks after spraining your wrist, whereas a cast may be necessary if the sprain is severe enough that even slight movement of the injured ligaments causes pain or an inability to bear weight on the wrist. Similarly, a splint is often used for simple or stable fractures, whereas casting is usually reserved for more complex fracture management.
In many cases, a splint is applied to an injury first, and then replaced by a full cast as the swelling subsides.
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How long to wear a cast
The length of time you need to wear a cast depends on the reason for wearing it and the severity of your injury. Casts are custom-made to fit the shape of your injured limb and are typically made of plaster or fibreglass. They are used to stabilise and protect your body after an injury, usually a broken bone, but sometimes a sprain.
Casts are often used to immobilise a joint or bone so it can heal properly. For example, you may need to wear a cast for several weeks after spraining your wrist. If you have a mild wrist sprain, your doctor may recommend that you treat it with rest, ice, compression, and elevation. However, if you have a more severe sprain, you may need to wear a cast for up to 8 weeks. Typically, you will only need to wear a cast for 3-4 weeks.
Most people need to wear a cast for six to eight weeks. It might take more or less time depending on how quickly your bone heals. Once your injury has healed, you can slowly start to reduce the amount of time you're wearing the cast until you no longer need it.
If you have a cast, it's important to take good care of it. Keep it away from dirt, dust, and sand, and avoid getting it wet or damp. Don't stick anything into the cast to relieve itching, and don't use skincare products, lotions, or baby powder on or near it.
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Cast risks and complications
While casts and splints are often used to aid in the healing process of sprains, there are some risks and complications to be aware of. The use of casts and splints involves immobilization, which can lead to several issues. Firstly, there is a risk of additional swelling, especially in fractures less than 2 to 3 days old, which may require a splint instead of a cast. In some cases, acute casting may be necessary despite this risk, such as in fractures with strong muscle forces or dislocation. If significant swelling occurs, the cast may become too loose, necessitating a splint instead.
Another complication of traditional casts is the practical disadvantages they pose to daily life. These include discomfort, sweating, having to carry around extra weight, and the inability to shower. The weight and bulkiness of traditional casts can also cause discomfort and hygiene issues. In addition, the cast must be completely removed for examinations or X-rays, which can be inconvenient.
More serious complications can also arise from the use of casts and splints. These include joint stiffness, disuse syndrome, muscle atrophy, and thrombos. Compression due to an excessively tight cast can lead to compression neuropathy, which slows nerve conduction and can cause pain and weakness. A particularly important complication is compartment syndrome, which occurs when increased pressure inside a compartment compromises the circulation and function of the muscle groups within it. Symptoms of compartment syndrome include pain with a burning sensation, delayed pain, increasing severity of pain, and pain during passive stretching of the affected area.
It is important to note that the decision to use a cast or splint should be made by a medical professional based on the location and severity of the injury. Splints are often used initially, and casts may be applied later as swelling subsides. The duration of immobilization depends on the type of injury and its severity, and it is crucial to follow the recommendations of a doctor to avoid further injury or delayed healing.
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Cast materials
Casts and splints are commonly used to support bones and joints while they heal from an injury. They immobilize the injured area, helping to reduce pain, swelling, and muscle spasms. Splints are usually made of softer materials like cloth or foam, while casts are made of harder materials like synthetic plastics, or traditional plaster.
Synthetic hard casts are made of fiberglass and have gained popularity in recent years over plaster casts. Fiberglass casts are more breathable and lightweight, making them more comfortable to wear. They are also more durable and can be X-rayed. However, they are more expensive and can be harder to mould.
Plaster casts are the more traditional option and are applied in a similar way to fiberglass casts. While neither material is waterproof, there are waterproof liners available for fiberglass casts.
Other cast materials include air casts, which usually consist of an air-filled splint in a hardened outer shell. These can be removed for washing and are suitable for strains and sprains, as well as bone fracture recovery.
Orthopedic casting supplies include customizable materials like casting tape, undercast padding, and stockinettes, as well as pre-formed plastic splints, air casts, and more.
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Cast alternatives
Splints
Splints are commonly used to support bones and joints while they heal from injuries. They immobilize the joint or bone, allowing it to heal properly and reducing pain, swelling, and muscle spasms. Splints are typically made of softer materials like cloth or foam, and they can be removed and reapplied as needed. The length of time a splint is worn depends on the severity of the injury and the affected body part. For example, a splint may be worn for several weeks after spraining a wrist, while it may be worn for a shorter time when recovering from carpal tunnel pain.
Pain Medication
Over-the-counter pain medications such as ibuprofen or acetaminophen can help relieve pain associated with sprains.
Strengthening Exercises
Stretching and strength training exercises can help improve the range of motion and strength in the affected area. However, it is important to consult a doctor before starting these exercises to ensure they are appropriate for the specific injury.
Opencast®
The Opencast® is a newly developed open cast for ankle sprains that provides more ventilation and is less likely to cause dampness when compared to conventional synthetic casts. However, it may make patients feel more vulnerable due to its visible and open nature.
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Frequently asked questions
While casts are typically used to support and protect injured bones and soft tissue, doctors may recommend a cast to treat a severe sprain. A splint is often used to immobilize a joint or bone so it can heal properly.
Typically, you will only need to wear a splint or cast for 3-4 weeks. However, if you have a more severe sprain, you may need to wear your splint or cast for up to 8 weeks.
Splints are a common alternative to casts. They are usually made of softer materials like cloth or foam and can be removed and reapplied as needed.
