We would recommend that air travel is delayed for at least 48 hours after a injured limb is placed in a cast. However, if air travel is essential most airlines will allow you to travel with a fit to fly certificate. There are some important points to consider:
When was the cast put on?
If your flight is less than 2 hours the cast needs to have been on for at least 24 hours.
If your flight is over 2 hours the cast needs to be on for at least 48 hours.
In some situations you may be able to travel sooner than that, for example if you have been placed in a backslab, which is when there is only plaster on one side of the limb secured with a bandage or when the plaster has been split, which is when a special saw is used to cut the plaster along its length to allow the limb to swell.
Where possible, we would recommend your cast is split before air travel.
Airline Restrictions & Policies
It's important to remember that all airlines will have their own rules on regulations, so we would advise that you should contact the airline as soon as you can after an injury to avoid any nasty surprises at the airport.
Seating Considerations
- If you are in a leg cast that goes above your knee the airline will often want you to book 3 seats so you can elevate your leg during the flight
- If you are in any type of cast or splint you wont be allowed to sit in emergency exit seats
Assistance
- Wheelchairs: The airline may be able to arrange a wheelchair for you to make your journey through the airport more comfortable. There will need notice to organise this, so the sooner you contact them the better
- Fast Track Security: This may be available to avoid you standing in long lines.
- Priority Boarding: This may give you more time to get onto the plane and seated
Medical Considerations
Risk of Swelling & Compartment Syndrome
Pressure changes in the cabin during a flight can result in fluid retention and swelling, especially in an injured limb
This swelling can result in compartment syndrome, where the swelling in the limb stops blood being able to flow, which is a surgical emergency. A tightly fitting cast can increase the risk of compartment syndrome so some airlines or healthcare professionals may suggest the cast is split for travel or you are placed in a backslab instead of a full cast. Please see our Cast Care blog for information about the different types of cast
Deep Vein Thrombosis (DVT)
A DVT is when a blood clot forms in a deep vein, most commonly in the legs or pelvis but can form in the arms.
If a piece of this clot breaks off it can travel to the lung and case a pulmonary embolism (PE), which can be life threatening.
There are well established links between air travel and blood clots, especially if the limb has been injured or is immobilized in a cast.
Please read our Blood Clots blog for more information about DVTs and PE, including risk factors and prevention techniques.
In-Flight Care Tips
Medications
- Make sure you have any medications you may need during the flight (such as painkillers or blood thinners) easily accessible.
Limb Positioning
- Keep the limb elevated above heart level when possible
- Pillows can be useful to rest the injured limb on. Either bring some with you or ask the cabin crew
- Wear loose, breathable clothing
Circulation & Movement
- If you can, do seated ankle pumps and leg stretches every 30–60 minutes
- Stand and walk if safe and medically allowed
Hydration & Diet
- Drink plenty of water (avoid alcohol and caffeine)
- Eat light meals to prevent bloating and fluid shifts
Red Flags to During or After Travel
Seek emergency care if any of the following occur:
- Numbness, tingling, or burning in fingers or toes
- Cast feels too tight or pain increases
- Cold, pale, or blue skin distal to the cast
- Significant swelling around cast edges
- Shortness of breath, chest pain, or coughing blood (possible pulmonary embolism)
Post-Flight Recommendations
- Inspect limb for swelling, redness, or discomfort
- Contact your local orthopaedic team or GP to schedule a post-flight review
- Monitor for late complications (DVT, cast integrity, delayed swelling)
