Collar and Cuff Sling

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A collar and cuff is a type of sling that the Nationwide Children's Hospital staff makes just for your child. This special sling will provide comfort to your child. It also helps keep the arm in the best position for proper healing of the injury and decreases swelling. It elevates the arm and minimizes large arm movements and rotation of the arm, which is important for healing. This is a very important part of your child’s treatment. Your child may take the collar and cuff off to bathe and to dress. Then the child should put the collar and cuff back on. Your child should wear the collar and cuff at all times when awake, unless told otherwise by the orthopedic health care provider.

How to Put on the Collar and Cuff Sling

  1. Put the padded area of the sling around the back of your child’s neck (Picture 1).
  2. Tie a secure knot above and below the cast (Pictures 23, and 4).
  3. Check that the sling is snug around the cast, so it does not slide. When the child is standing the arm should be shaped like an “L” or at a 90 degree angle (Picture 4). The hand should not be lower than the elbow. This will help prevent swelling in the hand and fingers.
  4. The material sometimes becomes stretched out and the sling will need to be repositioned and secured tightly again.

How to Put on a Sling


Your child will need help getting dressed. Try to minimize any motion to the injured arm.
When putting on a shirt, gently remove the collar and cuff and slide the shirt over the child’s injured arm first. This will help keep the arm from moving any more than needed. Then help the child pull the shirt over his or her head and slide the uninjured arm into the shirt sleeve.
When undressing, gently remove the collar and cuff. Then remove the clothing from the uninjured arm first. Assist the child with pulling the shirt over his or her head. Next, carefully slide the shirt down over the cast or splint and remove it from the injured arm.

Skin Care

  • Look for any red, dry, swollen, cracked or bleeding areas. Contact your child’s health care provider if you see any of these. For casts or splints on the arms, be sure to closely check the area between the thumb and fingers.
  • Do not use powders or lotions on the injured arm or around the collar and cuff sling. Lotion can make the skin too soft. Powder can collect under the splint or cast. This can cause pressure sores and other skin problems.
  • Do not stick anything inside the cast or splint. This may injure the skin and lead to infection. It could also disturb the lining of the cast and make it uncomfortable.
  • Do not pull the padding out of the cast. The padding protects the skin from injury.
  • Do not remove the cast or splint yourself.
  • You may clean the fingers of the injured arm with waterless soaps and sanitizers. These products should be used after going to the bathroom and before eating. Many different brands of sanitizers are sold at grocery stores and drug stores.
  • For more detailed Cast and Splint Care and Circulation Checks, please read these Helping Hands: HH-II-2 Cast and Splint Care and HH-II-60 Circulation Checks.


  • No gym, recess, sports, swimming or physical activities are allowed until approved by your child’s orthopedic health care provider. This is for your child’s safety and the safety of others.
  • Children with collar and cuffs may go to school if approved by their orthopedic health care provider. Sometimes they need help to carry books or bags and need to avoid crowded hallways and stairs.

When to Call the Doctor

  • If the circulation check or swelling of the fingers is not normal and does not improve after 1 to 2 hours with the arm elevated. (See Helping Hand HH-II-60, Circulation Checks.)
  • If your child’s pain is getting worse.
  • If your child is unable to move his or her fingers.
  • If your child has no feeling in the injured fingers.
  • If your child’s temperature is higher than:
    • 101 degrees Fahrenheit when taken by mouth (oral). Or
    • 101 degrees Fahrenheit when taken in the child’s bottom (rectal). Or
    • 100 degrees Fahrenheit when taken under the arm (axillary).
  • If your child’s pain does not get better or gets worse with the arm elevated, with ice application, or with pain medicine.
  • If the cast or splint gets wet and you cannot get it completely dry.
  • If you notice areas of red, dry, swollen, cracked or bleeding skin.

Follow-Up Appointments

An appointment has been made for your child’s follow up:

On: __________________________________________at ____________a.m./p.m.

Your appointment is with: ______________________________________________

at the following location:_______________________________________________


Call your child’s doctor or the Orthopedic (Bone) health care provider to arrange your

Follow up appointment ______________________________________ at (614) 722-5175.

Contacting Orthopedics

If you have any questions or concerns, call your child’s Orthopedic (Bone) Health Care Provider at Nationwide Children’s Hospital Orthopedic Center at (614)722-5175.

Collar and Cuff Sling (PDF)

HH-IV-147 7/15 Copyright 2015, Nationwide Children's Hospital