Podiatry - Non-removable Cast

Who is this information aimed at?

Your Podiatry Team have decided, following a full assessment, that a non-removable cast (a total contact cast) is the most effective form of treatment for your current foot problem. This leaflet contains important information and advice for patients requiring this treatment.

What is a total contact cast?

A total contact cast (TCC) is the recognised gold standard treatment for offloading the foot. A TCC is predominantly used in the treatment of Charcot Neuroarthropathy and diabetic foot ulcerations but can also be used to treat other foot conditions.

The cast is made of non-fibre glass tape and takes approximately 20-30 minutes to apply to your lower limb (usually toe to knee.) It is designed to reduce the pressure on your foot, by offloading weight onto your leg. A TCC can be needed for many months.
You will be seen on a regular basis (in most cases weekly) by the Podiatry Team for your cast to be removed, your feet to be checked and assessed and then the cast reapplied if required.

Looking after your cast

• Do regularly inspect the exposed area around your cast for signs of irritation. There is a risk the cast may rub and cause ulceration to another part of your foot or leg. Patients with neuropathy (loss of feeling) may not be aware that this is happening
• Do inspect the cast for signs of it becoming too tight or loose, soft or cracked
• Do regularly inspect the exposed area around your cast for signs of swelling, discolouration/changes to the skin or a feeling of tingling or numbness in your toes
• Do limit weight bearing. Rest as much as possible and only mobilise when essential
• Do elevate your leg on a soft surface with your toes higher than your hip joint, supporting the whole length of your leg
• Do tell your Podiatrist if your cast has been uncomfortable in a particular area of your foot or leg, as extra padding can be added at your next visit if needed

Wearing a cast on your leg can increase the risk of developing a Deep Vein Thrombosis (DVT) or Pulmonary Embolism (PE).

Symptoms of these include:

• Calf or thigh pain or swelling
• Sudden breathlessness
• Sudden pain in the chest or upper back that worsens on deep breathing
• Coughing up blood

Contact your Podiatry Team immediately on                             if you have any concerns about your cast. If this is out of hours (before 9am or after 5pm Monday to Friday or anytime during weekends) please visit your A&E Department.

• Do not get your cast wet. Waterproof cast protectors can be purchased if needed
• Do not push objects down your cast
• Do not try to remove the cast yourself

Next Podiatry Review:

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