The long arm cast may be used for:
- Mid to proximal forearm fractures
- Elbow fractures and dislocations
- Distal humeral fractures
What is a long arm cast used for in Orthotics?
A long arm cast is the most commonly used static orthosis for positioning the elbow (Fig. 13.5). After spasticity has been diminished by neurolytic or surgical techniques, the elbow is casted in maximum extension.
What is the difference between a forearm cast and a long arm cast?
A forearm cast is applied for these fractures for four to eight weeks. A long arm cast begins at the base of the fingertips and extends to the upper arm to immobilize the elbow joint. A long arm cast is used for fractures of the upper forearm, the elbow, and after elbow surgery.
What are the disadvantages of a long arm cast?
The long arm cast is applied according to standard procedure: If a complete cast is applied in the acute phase after injury, it is safer to split the cast down to skin over its full length. 3. Aftercare Further swelling in a restricting cast can cause pain, venous congestion in the fingers and occasionally a compartment syndrome.
How do you prepare a long arm cast?
Preparation of a long arm cast involves several steps. The practitioner may decide on the width of plaster or fiberglass to use that best fits the patient's anatomy. For adults, this often translates to 3-inch diameter sugar tong and 3 to 4-inch posterior mold material.
When is a long arm cast needed?
Unstable fractures require a long arm cast to control forearm rotation and therefore decrease the risk of displacement. In a very young child, or when there are concerns about compliance, a long-arm cast is always required.
What fractures require a long arm cast?
A long arm cast with the elbow extended is a useful but often forgotten technique to manage some pediatric fractures. Specifically, proximal forearm fractures of both the radius and ulna, olecranon fractures, flexion-type supracondylar fractures and type II Monteggia fractures are well managed in this manner.
Why would you need a full arm cast?
Casts immobilize the joint above and the joint below the area that is to be kept straight and without motion. For example, a child with a forearm fracture will have a long arm cast to immobilize the wrist and elbow joints.
What is long arm cast?
A long arm cast is used for fractures of the upper forearm, the elbow, and after elbow surgery. A long arm cast prevents the forearm from rotating to keep bones stable while healing. A long arm cast extends over the elbow joint. When applying a long arm cast, the patient's arm is maintained at a ninety-degree angle.
What is the most common bone broken in the arm?
The bones of the arm are also some of the most commonly broken, particularly the humerus. The humerus is the large bone between the shoulder and elbow and a break often occurs as a result of a fall or a collision.
What should you not do while wearing a cast?
Avoid placing powder, lotion or deodorant on or near the cast. Leave adjustments to your child's doctor. Don't pull the padding out of your child's cast. Don't trim the cast or break off rough edges without first asking your child's doctor.
How do they not cut your arm when removing a cast?
Against the firm surface of the plaster or fiberglass, the cast saw will cut through the material. However, against your skin, the cast saw simply moves the skin back and forth with the vibration, not cutting into the skin.
Do you need a sling for a full arm cast?
If you need to cover up or support an arm cast to protect against foreign bodies or further injury, consider getting a sling. These will help to support your healing, as well as to help keep things as comfortable as possible. You may also want to purchase protection if you need to continue working while injured.
What injuries require a cast?
Casts and splints may be used to help treat broken bones and injured joints and tendons, or after surgery involving bones, joints, or tendons. The purpose of a cast or splint is to immobilize a bone or joint while it heals from injury. This helps to restrict movement and protect the area from further injury.
What are the 3 types of cast?
Types of castsPlaster cast. This is made from gauze and plaster strips soaked in water. ... Synthetic cast. This is made from fiberglass or plastic strips. ... Cast brace. This is made of hard plastic. ... Splint (also called a half cast). This is made from slabs of plaster or fiberglass that hold the injury still.
How do you wear a long arm cast?
2:274:34Synthetic Casting Long Arm Application EN - YouTubeYouTubeStart of suggested clipEnd of suggested clipBegin by putting on protective gloves before applying the cast tape dip to inch or three inch castMoreBegin by putting on protective gloves before applying the cast tape dip to inch or three inch cast tape in water squeezing. One two three times remove from water and squeeze one time to remove excess.
How do you sleep with a long arm cast?
If it is your Arm, take the pillow from your bed and place it across your chest. Place the cast on the pillow to ensure that it is above your heart. A second option is to place pillows on either side of your elbow and point your fingers to the ceiling.
What fractures require a cast?
Common fractures treated in a cast include hand, wrist, forearm, lower leg, ankle and foot.
How long is cast for radius and ulna fracture?
Nonoperative Treatments. A stable, simple and isolated fracture of the ulna (secondary to a direct blow) can be treated with a cast for about four to six weeks. Your doctor will closely follow your progress with X-rays to assure nondisplacement of the fracture and proper bone healing.
Does every fracture need a cast?
A cast is one option for treating a broken bone, but it is not the only treatment option. Other broken bone treatment options include splinting, taping, bracing, placing the affected bones in a sling, and surgery. As mentioned, finger fractures are often treated with taping.
Do all hairline fractures need a cast?
Yes. Treating a hairline ankle fracture often begins with RICE - Rest, Ice, Compression, and Elevation. You may be advised to take over-the-counter pain medication like aspirin or ibuprofen. Crutches or a cast may also be necessary to make sure the bone properly heals.
How to treat TFCC?
The treatment of acute TFCC lesions initially is conservative. Long arm cast immobilization is used if the patient does not have a fracture of the ulnar styloid or instability of the distal radioulnar joint. If the tear is peripheral and acute, the highly vascular tissue is likely to scar together over a 4- to 6-week period. If the tear is more central, it is not expected to heal, although the synovitis associated with it may diminish and the symptoms of wrist pain may abate. Central tears do not cause instability and require treatment only if they are painful. Patients who present acutely but have instability of the distal radioulnar joint should undergo ligament repair.
What is a long arm cast?
A long arm cast is the most commonly used static orthosis for positioning the elbow ( Fig. 13.5 ). After spasticity has been diminished by neurolytic or surgical techniques, the elbow is casted in maximum extension.
What is dropout cast?
A dropout cast is a modified long arm cast in which the posterior portion of the cast above the elbow has been removed, allowing for full extension but limiting flexion ( Fig. 13.6 ). It can be used as a dynamic orthosis controlling therapeutic range of motion of the elbow. This cast is purposely made heavy, or weights are added at the wrist to encourage elbow extension. A dropout cast is effective only in patients who are in an upright position for much the day because the arm must be hanging freely for the device to work. As with the long arm cast, a dropout cast can be serially modified to increase elbow extension range of motion.
How to treat Kienbock's disease?
The patient should be immobilized in a double-sugar tong splint or a long-arm cast well molded over the wrist to compress the lunate area. The patient should then be referred to an orthopedist promptly for close follow-up. Most patients require several weeks of immobilization with radiographic studies at frequent intervals. Several retrospective studies have suggested better results with surgical management compared with conservative treatment.14,15 The definitive surgical method for treatment of patients with Kienbock's disease is still debated. Ulnar lengthening or radial shortening has been used to decrease stress on the healing lunate. Other surgical procedures include lunate excision, prosthetic replacement, and intercarpal fusion.
How long to cast a fractured arm?
Type I—posterior splint for 3 to 5 days followed by a long arm cast for 3 weeks. Type II—treat with splint, followed by cast in flexion, must recheck alignment in 5 to 7 days and if there is displacement then closed reduction and percutaneous pinning (CRPP). Some perform CRPP acutely in type II fractures. Type III—CRPP. The deformity should not be exaggerated, so as to avoid injuring the brachial artery. Longitudinal traction/countertraction, varus-valgus angulation, and rotation are corrected and the distal fragment is pushed forward while the forearm is pronated. The goal of CRPP is to construct stability via cross pinning with two equal lateral divergent pins, two parallel lateral pins, or two pins crossing at or near the fracture site.
What is a short arm C?
short-arm c. (SAC): any of a number of casts extending from the elbow to the palm or fingers; commonly used for distal forearm and wrist fractures.
How long does it take for a child to get a fractured elbow?
In the young or rambunctious child, or if exposed percutaneous pins were placed, place the elbow in a long-arm cast or splint until fracture union, typically 4 to 6 weeks. For more mature children, early protected motion can be initiated within the first 2 weeks postoperatively.
Why do you need a long arm cast?
A long arm cast should always be used where it is necessary to control forearm rotation in order to prevent fracture displacement. In very young and in noncompliant children, a long arm cast is preferable even if a short cast would otherwise be appropriate
What is compartment syndrome?
Compartment syndrome is an unusual but serious complication after the application of a complete cast and can be difficult to diagnose, especially in younger children. Neurological signs appear late and the main sign is excessive pain on passive extension of the fingers.
Why is plaster of Paris cast so loose?
If a normal plaster of Paris cast is used, it is important to keep the cast clean and dry in order to maintain the reduction. When the swelling has reduced, the cast can become loose. The loss of support can result in loss of reduction.
How long after reduction can you take an x-ray?
In the older child with a potentially unstable fracture, an x-ray would normally be taken at 7-10 days.
How to tell if you have nerve compression?
It is important for them to detect these signs as early as possible and report them urgently to the surgeon/nurse by telephone, or to attend the Emergency Room (ER) without delay . Nerve compression is an occasional complication and the signs include: Sensory deficits (numbness) Weakness of active finger movement.
What are the symptoms of nerve compression?
Nerve compression is an occasional complication and the signs include: 1 Sensory deficits (numbness) 2 Weakness of active finger movement 3 Paresthesia (tingling)
Can a fracture be redisplaced?
For complete fractures of the metaphysis, redisplacement after reduction is not uncommon. It is therefore, important to take early follow-up x-rays in order to detect a possible redisplacement.
Arm Casts
Five-year old Lulu just had her training wheels taken off of her bike and is riding by herself for the first time. She wobbles and then falls off her bike and lands on the sidewalk. Lulu attempted to break her fall with her outstretched hand and immediately feels pain in her arm. It's broken, and she needs an arm cast.
Short Arm Casts
A short arm cast extends from below the elbow to the base of the fingertips. It allows the elbow to move normally. Short arm casts are used for fractures at the wrist or forearm. A short arm cast is also used after surgery on arm tendons to prevent the arm's movement as the injury heals.
Forearm Cast
A forearm cast is another term for a short arm cast. It begins at the base of the fingertips and allows freedom of finger movement and extends to just below the elbow.
Long Arm Casts
A long arm cast begins at the base of the fingertips and extends to the upper arm to immobilize the elbow joint. A long arm cast is used for fractures of the upper forearm, the elbow, and after elbow surgery. A long arm cast prevents the forearm from rotating to keep bones stable while healing.
What is a cast?
A cast holds a broken bone in place as it heals. Casts also help prevent or decrease muscle contractions, and are effective at providing immobilization, especially after surgery.
What are the different types of casts?
Below is a description of the various types of casts, the location of the body they are applied, and their general function.
What is a thigh fracture?
Thigh fractures. Also used to hold the hip or thigh muscles and tendons in place after surgery to allow healing. One and one-half hip spica cast. Applied from the chest to the foot on one leg to the knee of the other leg. A bar is placed between both legs to keep the hips and legs immobilized. Thigh fracture.
What is a cylinder cast?
Arm cylinder cast. Applied from the upper arm to the wrist. To hold the elbow muscles and tendons in place after a dislocation or surgery. Type of cast. Location. Uses. Shoulder spica cast. Applied around the trunk of the body to the shoulder, arm, and hand. Shoulder dislocations or after surgery on the shoulder area.
Why do you put toilet paper in a cast?
Place toilet paper inside the bedpan to prevent urine from splashing onto the cast or bed.
How to promote circulation in children?
Encourage your child to move his or her fingers or toes to promote circulation.
How to prevent a child from eating with a cast?
Cover the cast while your child is eating to prevent food spills and crumbs from entering the cast. Prevent small toys or objects from being put inside the cast. Raise the cast above heart level to decrease swelling. Encourage your child to move his or her fingers or toes to promote circulation.
How to keep plaster from getting wet?
Keep your cast or splint clean and dry unless it is made to be waterproof. Being in contact with damp padding can irritate your skin. Plaster gets softer and weaker when it gets wet. Here’s how to keep it dry: 1 Use plastic bags or a waterproof cast cover to keep your splint or cast dry when bathing. Seal the bag with tape or rubber bands so there is a water-tight seal. 2 Elevate your hand in the shower above your head to avoid water running under the seal and into your cast. 3 Remove the bag or cover afterward. Do not keep it constantly covered because moisture may build up from normal sweating.
What is an arm cast?
Arm Cast Materials. An arm cast is made with plaster or “fiberglass” to form the hard, supportive outer layer. Fiberglass is lighter, more durable, and “breathes” better than plaster. Some fiberglass casts are also waterproof, depending on the underlying padding material (ask your doctor if such a cast is appropriate and available ...
How to clean a cast that is wet?
When you come in contact with chlorinated water or dirty water, rinse the cast with fresh water when done. Allow the inside of the cast to drain as much as possible after it gets wet. If you have a cast that goes past your elbow, be sure to drain the area around the elbow well. The rest of the water will evaporate.
Why do people use splints?
Splints are often used in the immediate post-surgery or injury phase. This is because a splint can better allow for the swelling that often occurs in these situations. Your doctor will decide which type of support is most appropriate for you and your arm condition.
What is a splint made of?
A splint can be made with these same materials or with plastic, fabric, or padded aluminum. They can be custom-made, or they may be pre-made. They come in a variety of shapes and sizes, depending on the specific need. They often have Velcro straps or similar closure systems, and this makes them easier to take on and off.
Why do you need a cast?
Remember, a cast is there to protect you while your injury heals. It is only a temporary inconvenience, with the goal of helping you recover.
Why can't you put anything in a cast?
If you feel itching, do not place anything inside your cast because you can injure your skin; ask your doctor for advice.
What are long arm casts used for?
Long arm casts are largely used for fractures to bones higher up on the arm compared to injuries requiring short arm casts. Examples of injuries and situations that require long arm casts include: Fractures and dislocations of the elbow. Fractures to the forearm near the elbow.
What is the difference between a long arm and a short arm cast?
Obviously, long arm casts are much longer than short arm casts. These types of casts start from about the middle of the humerus (bone in the upper arm) and extend down the arm all the way to the base of the fingers (it also extends between the thumb and the pointer finger). When long arm casts are applied, the elbow is usually bent at a 90 degree angle and the wrist is either in a neutral or slightly extended (bent backwards) position.
What are the two types of casts used for forearms?
This lesson will teach you about two specific types of casts used for these injuries: short arm and long arm casts. Create an account.
What causes a fractured wrist?
Fractures to the wrist, forearm, and elbow are fairly common and can be caused by something as simple as tripping while playing with your kids (like Greg) or even tripping while walking. Two types of casts used for fractures to the wrist, forearm, and elbow include short arm and long arm casts. Lesson. Quiz.
Why do greenstick fractures occur?
Greenstick fractures: fractures to the soft bones of the forearm in young children that occur because the soft bones bend too far and break
What is a temporary cast on your arm?
During this time, a temporary splint is usually applied to help keep the arm immobilized while allowing space for additional swelling. Once the swelling goes away, these casts are then applied to the injured arm. Lesson Summary. Short arm and long arm casts are two types of casts frequently used for fractures and other injuries to the wrist, ...
Where do short arm casts start?
Short arm casts usually start from the forearm near the elbow and extend to the base of the fingers. When short arm casts are applied to the arm, the wrist is usually in a neutral position. This type of cast is used for several different types of injuries, which include: Colles and Smith fractures: fractures to the radius (bone on the thumb side ...
How to assemble a long arm cast?
To efficiently assemble a long arm cast, the practitioner should recruit the help of at least one other person. Have an assistant hold the patient's extremity in the desired position of immobilization while the splint is being created and molded.
How to apply a sugar tong to the wrist?
Next, the prepared plaster or fiberglass sugar tong is dunked in cold water and applied around the elbow to the dorsal and volar aspects of the wrist. Care should be taken to stop the material approximately 1 cm short of the distal web roll to allow for an adequate bumper for soft tissues in the hand and not to restrict metacarpal phalangeal joint motion. The sugar tong is overwrapped with one layer of web roll to prevent circumferential immobilization once the posterior mold is applied, which would not allow for expansion.
What is a long arm splint?
Long arm splints are often the initial form of immobilization placed on an injured limb to accommodate soft tissue swelling before more definitive treatment with a cast or surgical fixation.
How many layers of web roll for splint?
The number of layers is determined by the amount of expected swelling, but many splints will use two to four layers. Care should be taken to accurately define the distal borders of the splint to allow for free motion of the thumb and metacarpal phalangeal joints. At the elbow, web roll must be carefully applied to ensure adequate padding of the olecranon. Frequently, the practitioner can tear pieces of web roll to lay on the posterior aspect of the elbow to provide padding without overbulking the antecubital fossa. Web roll should be extended proximally, often to the proximal one-third of the humerus. Also of note, it is important to lay on web roll with 50% overlap to maintain even padding without irregularities, which can be a source of irritation. To achieve this, anatomy, which is more cone-like than cylindrical (e.g., forearm), may require interrupting wraps rather than continuous circumferential layers.
How big is a sugar tong?
For adults, this often translates to 3-inch diameter sugar tong and 3 to 4-inch posterior mold material. For pediatrics, 2-inch sugar tong and posterior mold often work well. For plaster and fiberglass, the length of the sugar tong and posterior splint should be pre-measured.
How many layers of plaster are used for splinting?
With plaster, eight to 10 layers are often used. For fiberglass, most splinting materials come pre-fabricated. Synthetic or cotton web roll should be obtained for padding. Optionally, stockinette can be used for patient comfort as a base layer before splinting.
What is the purpose of a sling?
In most clinical situations, a simple sling provides enough patient comfort/immobilization
How long does it take for plaster casts to harden?
They also take several days to fully harden, so you’ll need to limit your activities for a few days after getting the cast. Plaster casts tend to be heavier as well, so they can pose a challenge to small children.
What is synthetic cast?
Synthetic casts are the modern option. Today, synthetic casts are used more often than plaster casts. They’re usually made out of a material called fiberglass, a type of moldable plastic. Fiberglass casts are applied in a similar manner to plaster casts. A stockinette is placed on the injured area, then wrapped in soft cotton padding.
Why are splints called half casts?
Splints are often called half casts because they don’t fully surround an injured area. They typically have a hard, supportive surface made of plaster, plastic, metal, or fiberglass. This material is usually lined with padding, and Velcro straps hold everything in place. Many injuries requiring casts initially cause swelling.
What is the difference between a plaster cast and a synthetic cast?
Synthetic cast pros. Synthetic casts offer a lot of advantages over plaster casts for both doctors and the people wearing them. They’re more porous than plaster casts , which allows your doctor to take X-rays of the injured area without removing the cast.
Why are casts used?
Why casts are used. Casts are supportive devices used to help keep an injured bone in place while it heals. Splints, sometimes called half casts, are a less supportive, less restrictive version of a cast. Casts and splints may be used to help treat broken bones and injured joints and tendons, or after surgery involving bones, joints, or tendons.
How long does it take for a fiberglass cast to dry?
The fiberglass is then soaked in water and wrapped around the area in several layers. Fiberglass casts dry within a few hours.
Can a cast help with swelling?
Many injuries requiring casts initially cause swelling. Splints are easily adjustable, so they’re often used to help stabilize the area until the swelling goes down. Once the swelling subsides, your doctor can get a better look at the injury and decide if a more supportive cast is needed.
