Advice after your nerve block for surgery
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Introduction
You have been fitted with a plaster cast for a broken bone, soft tissue injury, or following a surgical procedure. This cast is designed to immobilise and support the affected part of your body to allow proper healing. Depending on your injury, various materials may be used, but the fundamental care instructions remain identical.
CRITICAL ADVICE: It is vital that you regularly exercise and move all joints not restricted by the cast (e.g., fingers, toes, elbow, knee, or hip). Do not let mild discomfort prevent you from doing these exercises, as they prevent stiffness and maintain circulation.
Managing Your Affected Limb
To actively reduce swelling and enhance blood circulation, please strictly follow these instructions:
- Arm Casts: Keep your arm elevated as much as possible, ideally with your wrist positioned higher than or level with your heart. Use a sling if provided, but remove it periodically to exercise your shoulder and elbow.
- Leg Casts: Elevate your leg whenever seated or resting, keeping your big toe in line with your heart. DO NOT place a pillow directly under the heel of the cast as this concentrated pressure can rapidly cause a painful pressure sore. Support the leg along the calf instead.
Weight Bearing Definitions
| Weight Bearing Status | Description |
| Non-Weight Bearing (NWB) | Strictly no weight is to be passed through the affected limb. You may rest your foot lightly on the floor while seated, but it must remain completely off the ground when standing or moving. |
| Toe-Touch Weight Bearing (TTWB) | You may only touch your toes to the floor strictly for balance. No actual body weight should be transferred through the limb. |
| Partial Weight Bearing (PWB) | You are permitted to clear approximately 50% of your body weight through the affected limb while walking, or as specifically instructed by your team. |
| Weight Bearing As Tolerated (WBAT) / Fully Weight Bearing (FWB) | You are allowed to walk and bear weight using a cast shoe and any prescribed mobility/walking aids. |
Essential Rules for Cast Care
- Keep it completely dry: Do not submerge or expose the cast to water. Plaster of Paris takes 48 hours to fully dry, and synthetic casts take 2-3 hours. Use purpose-made waterproof covers for bathing, available at pharmacies. Use wet wipes for fingers/toes.
- Never insert items inside: Do not scratch under the cast using coat hangers, knitting needles, or other objects. This can easily tear the skin, leading to severe, unseen infections.
- Do not alter the cast: Never cut, trim, file, or reshape your cast yourself. If it feels sharp or uncomfortable, contact the Plaster Room.
- Avoid using adhesive tape: Do not use tape to repair a cracked or damaged cast. The casting material is designed to breathe; sealing it with tape causes moisture build-up and skin maceration/odour.
- Do not drive: It is strictly advised that you do not drive any motor vehicle while fitted with a plaster cast, as it impairs control and voids most insurance policies.
Warning: Deep Vein Thrombosis (DVT) & Pulmonary Embolism (PE)
Immobilisation of a limb increases the risk of blood clots forming within your deep veins (DVT). If a portion of a clot breaks away, it can travel to the lungs, causing a life-threatening blockage known as a Pulmonary Embolism (PE).
| DVT Symptoms (Leg Clot) | PE Symptoms (Lung Clot) - URGENT |
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When to Seek Immediate Medical Attention
Go straight to the Emergency Department (A&E) or call 999 if you experience any PE symptoms, or if your fingers/toes become blue, cold, heavily swollen, or numb, and do not improve after 30 minutes of continuous elevation.
Contact Fracture Clinic immediately if:
• The cast breaks, cracks, softens, or becomes excessively loose.
• The cast feels too tight and causes constant throbbing.
• You feel a burning or rubbing sensation, indicating a potential pressure ulcer.
• An object has accidentally slipped down inside the cast.
• There is an unpleasant smell, wetness, or discharge coming from inside the cast.
Contact us
If you have any queries relating to this information, please contact the Emergency department (ED) service.
About this information
Service:
Emergency department (ED)
Reference:
A/036
Approval date:
1 October 2026
Review date:
1 October 2029
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.