Arm Cylinder Cast

Other Names

• Arm Cylinder Cast

---

Background

• This page refers to the arm cylinder cast
  • Extends from mid arm to mid forearm
  • Different from the long arm cast, which extends down to the hand/wrist

---

Indications

• Elbow Dislocation

---

Contraindications

• Most acute fractures
• Open fractures
• Injuries with neurovascular compromise
• Fractures with active swelling

---

Procedure

Equipment

• See: Casting materials

Technique

• Patient position
  • The elbow is casted at 90°
  • Note the wrist/ hand are not immobilized
• Stockinette/ tubular bandage
  • Start on proximal 1/3 of humerus
  • Extend down to distal 1/3 of forearm
  • Cut about 5 cm of extra length on each end of the stockinette
• Cast padding
  • Wrap circumferentially from distal to proximal
  • Typically a 2-4 layers of padding is sufficient
  • There should be no creases in the stockinette or cast padding
• Cast material
  • Wrap from distal to proximal
  • For plaster, 4-6 layers is adequate; for fiberglass, 2-4 layers is adequate
  • Trim excess material to accommodate thumb and fingers
  • Fold the proximal and distal ends of the stockinette over the cast
  • Apply an additional layer of cast material
• Apply a 3 point fixation at the fracture site until the material hardens
• Confirm neurovascular exam

Pearls and Pitfalls

• Care should be taken to ensure cast does not restrict flexion of MCP joints
• Place in a shoulder sling for comfort

---

Aftercare

• Typically non-weight bearing until re-evaluated
• Advise patient to keep cast or splint clean and dry
• Do not insert objects into splint/ cast
• Monitor for complications (worsening pain, paresthesia/ numbness, color changes)
• Seek further care if unable to control pain at home

---

Complications

• Acute Compartment syndrome
  • The ability to passively/actively extend fingers without discomfort indicates absence of muscle compartment compression
• Plaster burn/ thermal injury
• Pressure sores
• Nerve palsy
• Vascular compromise
• Splint dermatitis
• Permanent joint stiffness
• Skin infection
  • Cellulitis from underlying wound, pressure ulcers

---

See Also

• Casting Main
• Procedures Main

---