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Arm Cylinder Cast

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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


Contraindications

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

Procedure

Equipment

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

See Also


References

Created by:
John Kiel on 15 July 2023 14:33:14
Authors:
Last edited:
31 July 2023 15:06:25
Category: