Hand Fracture and Cast: How to Care for Your Child

A cast can help a fractured (broken) hand heal by holding the bones in place. You can help your child be comfortable while the hand is healing.

The bones inside the palms of the hands are called metacarpal bones. They connect the wrist bones to the fingers. One or more of these bones can break or crack from a direct blow to the hand, during sports or a fall, or when the hand punches a hard surface.

Your child's hand fracture was diagnosed after a physical exam and X-rays showing the broken bone(s). If the bones were out of place, the health care provider straightened them after giving medicine to keep your child comfortable.

Health care providers often treat hand fractures with a cast. The cast is usually removed after 4–6 weeks. Some fractures that do not heal well on their own may require surgery to bring the broken pieces of bone together, but this is not common.

• For the first 24–48 hours after the fracture:

  • The hand may be sore for a few days. Give your child pain medication as directed by your health care provider.

  • Use pillows to prop the cast above the level of your child's heart.

  • Apply cold packs wrapped in a towel over the cast for 20–30 minutes at a time for 24–48 hours.

• Do not get the cast wet. Use a plastic covering over the cast as directed while bathing and prop it on something like a plastic milk crate to keep it completely out of the water. Older kids should avoid showers. Give sponge baths to kids under 5 years old.

• Don't allow your child to use any object to scratch under the cast. It can lead to sores on the skin or an infection. Don't apply lotion or powder inside the cast.

• For itching, tap lightly on the cast or use a cool hair dryer to blow air in and around the edges.

• Encourage your child to wiggle the fingers to keep blood circulating normally.

• If a sharp edge on the cast irritates your child's skin, apply tape or moleskin to the edge.

• Make any follow-up appointments as directed.

• Follow the health care provider's instructions about when your child can return to sports and other activities.

• Your child's pain isn't relieved by pain medication.

• You think something might be stuck in the cast.

• There is a foul odor or drainage coming from the cast.

• The skin around the edge of the cast is red or raw.

• Your child develops a fever.

• Your child's fingers turn pale or blue.

• The cast feels too tight or your child's hand feels numb and tingly.

• The cast is cracked, loose, or wet.