Serial Casting: Post-casting Program

These instructions are for caregivers of Children's Hospital of Philadelphia (CHOP) patients who have completed casting and moved on to splints.

Important information:

Your child's cast has been removed and now they need to wear splints to maintain range of motion in their joint. Splints also help increase flexibility in the elbow, wrist and hand. The cast relaxed your child's muscle tone to allow more movement. The splints help to keep it that way! If your child does not wear the splints, they can get contractures in 2-3 days. Muscle tone can increase in just a few hours. It is very important to follow the splint schedule below.

Patient instructions: splint schedule

Week 1

Wear splints overnight and during the day. You may remove them for 1 hour, 4 times a day. This is usually enough time for bathing and dressing. Stretch the arm when you remove the splint.

Week 2

Remove the splints every 3 hours for up to 2 hours during the day. Wear them all night. Stretch the arm when you remove the splint.

Weeks 3-4

Wear the splints for 4 hours during the day and all night. Stretch the arm when you remove the splint.

Weeks 4 and after

Always wear the splints at night. Stretch the arm when you remove the splint. The therapist may change the daytime schedule to meet your child's needs.

Additional instructions:

• Stretch the arm when the splint is off.

• Encourage as much active movement as possible in the shoulder, elbow, wrist, thumb and fingers.

• Help your child with weight-bearing activities, as instructed by the therapist.

• Please follow the splint care instructions.

Contact your therapist with any questions about your child's splints.

Reviewed on January 10, 2023, by Megan Beam, PT, DPT; Stacey Caviston, PT, DPT; Ken Knecht, PT, MS