Page 77 - Orthopedic Casting Manual

1.2 Introduction: Purpose and

Importance of Casting for the

Upper Extremity

Or thopedic c asting is a cr itic al inter vention for the tre atment of a wide range of musculoskeletal conditions
affecting the upper ex tremit y. The pr imar y pur pose of c asting is to immobilize the affected region, thereby
providing structural suppor t, reducing p ain, promoting tissue he aling, and preventing fur ther injur y. Casting plays
an essential role in the management of fractures, soft tissue injur ies, and cer tain joint disloc ations, as it stabilizes
the bones and joints in their proper anatomic al alignment. This immobilization facilitates natural he aling
processes while minimizing complic ations such as malunion, nonunion, or chronic instabilit y LRicci et al., 2018M.

Upper ex tremit y injur ies, including fractures of the radius, ulna, humerus, and wr ist, are among the most common
musculoskeletal injur ies tre ated in clinic al practice. Proper c asting techniques ensure optimal outcomes by
addressing both the mechanic al and biologic al requirements of bone and tissue he aling. Mechanic ally, c asts
provide ex ter nal stabilization, maintaining the injured limb in a position conducive to he aling while limiting motion
that could disrupt the rep air process. Biologic ally, they protect the injur y site from ex ter nal stressors and promote
the natural inflammator y and rep arative processes cr itic al to recover y LCour t-Brown & McQueen, 2016M.
Another crucial aspect of c asting is its role in reducing the r isk of secondar y complic ations. Improper ly
immobilized fractures or soft tissue injur ies c an le ad to long-ter m functional imp air ments, including reduced
range of motion, chronic p ain, or defor mities. For example, in distal radius fractures, maintaining proper
alignment and immobilization is cr itic al to preser ving wr ist function and avoiding complic ations such as c ar p al
instabilit y or ar thr itis LMulders et al., 2019M. Effective c asting minimizes these r isks by ensur ing the injured
structures remain proper ly suppor ted throughout the he aling process.
In addition to its therapeutic pur poses, c asting ser ves an impor tant diagnostic and preventative role. By
stabilizing the upper ex tremit y, it allows he al thc are providers to assess the p atientʼs recover y progress more
effectively. Immobilization c an also ser ve as a protective me asure in conditions such as ligament sprains or
tendinitis, where restr icting movement reduces the r isk of exacer b ating the injur y. Moder n advancements in
c asting mater ials, such as fiberglass, have improved p atient outcomes by offer ing light weight, durable, and
water-resistant options that enhance comfor t and compliance LBer trand et al., 2018M.
Finally, c asting for the upper ex tremit y is integral to pediatr ic and ger iatr ic c are, where unique anatomic al and
physiologic al factors must be considered. Pediatr ic p atients, for instance, are at higher r isk for growth plate
injur ies, necessitating precise c asting techniques to prevent growth distur b ances. Conversely, older adul ts are
more prone to osteoporosis-related fractures, requir ing additional attention to prevent
complic ations such as skin bre akdown or pressure sores LSchmitt et al., 2019M. By addressing these diverse
p atient needs, or thopedic c asting remains a cor nerstone of effective upper ex tremit y injur y management.