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to consider taking a pair of secateurs to my plaster cast?

(15 Posts)
Backinthebox Mon 04-Jul-11 22:08:44

I broke my leg 8 days ago, but it took 4 days for the swelling to come down enough to put the screws in it and put a plaster cast on it. Until this point my leg hurt, but not my foot. After all, it is my leg that is injured. After they put the cast on it my foot has been in agony. I went back to the hospital on Saturday, where the nurse I saw confirmed my cast is too tight and tried to stretch it a little but said she could not remove the cast until Wednesday this week due to the incisions that were made to insert the screws needing to be kept as clean and untouched as possible. It was a temporary relief to have the cast slackened a little, but it's not been enough. The best way I can thing to describe it is if you wrap a little bit of thread around the end of your finger it doesn't hurt to start with, then it gets a bit uncomfortable, and if you don't remove it, it will eventually become excrutiating.

Obviously I am not going to stick a pair of secoteurs up by the incisions, but AIBU to just trim a little bit near my toes to take the pressure off my foot? Just a wee, tiny, little bit? I'll try not to cut a toe off or anything...

hiddenhome Mon 04-Jul-11 22:13:12

Crikey, are you sure your toes still have a blood supply? They shouldn't have left you in this state.

I can't see that removing a small amount of cast would do any harm.

ChocolateTeacup Mon 04-Jul-11 22:44:06

Keep well away from the injury but remove some plaster

You need to be very careful indeed, Backinthebox. If you cause a skin abrasion inside the cast, or if a bit of plaster of paris goes up inside the cast and rubs, it could cause an infected lesion which you wouldn't be able to see, possibly until too late. Please don't fiddle with your cast - you could cause some really serious problems.

Get someone to check your toes for sensation - you can't do it yourself as you need not to look or know what's happening. Ask someone to touch your toes and you tell them which toe they are touching. Ask them to pinch the toes, and see if the toe 'pinks up' quickly after it is released. A sluggish return of blood to the toes and/or lack of sensation would be worrying symptoms and I would go straight back to A&E.

PrinceHumperdink Mon 04-Jul-11 22:46:44

Message withdrawn at poster's request.

lalabaloo Mon 04-Jul-11 22:47:57

It sounds incredibly uncomfortable, I really think you should be asking them if it is possible to do something sooner than Wednesday. I understand about the incisions needing to be kept clean, you may need to ask them which is more important. I'm not sure about doing something yourself in case you accidentally do any damage (I panic if I do DIY surgery/adjustments to anything medical and imagine myself in hospital because of something I did wrong!) Is there an out of hours number you could call for advice?

ddubsgirl Mon 04-Jul-11 23:00:45

ugh my ds2 got a coathanger stuck in his few weeks ago,4 hour trip in a&e and got home at 3am,was not impressed,i would go back to frature clinic if cast is too tight,dont wait till wednesday

I hope the OP is off to A&E. As a nurse, I have heard horror stories about infected wounds inside plasters, and would urge you all - DON'T SCRATCH INSIDE YOUR CAST OR STICK THINGS DOWN INSIDE IT, OR CHIP BITS OFF IT. Please.

Sorry to shout.

ddubsgirl Mon 04-Jul-11 23:17:40

yep my son found out the hard way lol!altho the way the a&e staff cut and tried to get his cast off was shocking!lucky it wasnt broken(he has tendon & ligament damage)or it could have done alot of damage to the break.

jasper Mon 04-Jul-11 23:32:40

back, following foot surgery some years ago I had casts on both feet that dug in really painfully ( not near the surgery wound) . it was very obvious that the cast had been over extended. I went back to the hospital and they took special trimmer things to it and lopped off about half an inch and the relief was instant and wonderful. My brother is a doctor and he said it was quite common for plaster casts to be over extended/ digging in/ tight and needing trimmed a bit.

I think you should phone the hospital and explain that the discomfort is nowhere near the break and I can't see why they would not trim it a bit.

Tchootnika Mon 04-Jul-11 23:38:01

OMG, OP, you sooo have my sympathy.
Definitely tell them at hospital, but in the meantime, is your foot raised above leg? (i.e. blood flowing away from foot rather than into it?)

Backinthebox Wed 06-Jul-11 08:53:40

Well, OH did a bit of DIY on Monday night on the cast which helped a little bit, and then I went back to the plaster room on Tuesday morning, where the plaster technician removed the cast (with some swearing!) and was able to point out the places where it had been digging into my ankle. The place that had been squished corresponds with a part of the ankle where the nerve to the big toe runs, so it could have been slowly strangled or, they were keen to point out, could have been nicked during surgery. Either way it will take some time for the feeling to return to my toe and for the top of my foot to stop hurting.

Someone more qualified than I could perhaps confirm that if the nerve had been nicked during surgery, I wouldn't have had the feeling in my toe when I came out only to lose it slowly over the next few days? hmm More likely to be nerve compression?

jenniec79 Wed 06-Jul-11 09:20:27

Much more likely to be stretched or squashed, but the end result is still that it'll take time.

Hopefully you've a more comfortable, better padded cast now?

Never stick anything down a plaster; if it's tight, elevate the limb(above heart height) keep it there, wiggle fingers/toes (as relevant) and if still not settling go to plaster room (in hours) or A&E (out of hours). They have a proper plaster saw and can take it off and check wounds, but more important that it doesn't get too tight.

And never stick anything down a plaster!

Backinthebox Wed 06-Jul-11 09:33:13

I have a removable fibreglass splint running down the back of my calf and under my foot to stop me stretching my ankle out, but it is held in place by a crepe bandage. I can take it off to shower and it is easier to put ice on my ankle. Apparently because I have had my ankle screwed back together and I am not to put any weight on it AT ALL it doesn't need holding together rigidly to a big heavy constricting cast isn't going to be any better than hardly any cast at all. After more of the swelling has gone down I will have a full cast put back on next week.

At that point, I'd assume you would be able to have a fibreglass cast rather than a plaster of paris one, Back. I'd definitely ask for one. At our local hospital they do offer fibreglass casts, but if you are an adult, you have to have a boring white one - only kids get a choice of colours.

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