Page 79 - Orthopedic Casting Manual

1.3 Upper Extremity Casts -

Overview

Or thopedic c asts are tailored to address specific injur ies of the upper ex tremit y. Each t ype of c ast is designed to
provide appropr iate immobilization, promote he aling, and prevent fur ther damage. The following sections outline
the most common t ypes of upper ex tremit y c asts, their indic ations, and the steps for their applic ation.

Short Arm Cast

The shor t ar m c ast is one of the most commonly used c asts for upper ex tremit y injur ies. I t ex tends from just
below the lbow to the knuckles, le aving the fingers free.

Indic ations: Shor t ar m c asts are pr imar ily indic ated for distal radius fractures, wr ist fractures, and other
conditions requir ing immobilization of the wr ist joint without restr icting elbow movement. These conditions may
include nondisplaced or minimally displaced fractures of the sc aphoid, stable metac ar p al fractures, and cer tain
soft tissue injur ies
LMulders et al., 2019M.
Applic ation Steps:
✓ Position the wr ist in relaxed supination.
✓ Apply the c asting mater ial (fiberglass or plaster) in layers, star ting from the distal end and moving proximally.
✓ Mold the c ast c arefully over bony prominences, such as the radial and ulnar st yloid processes, to avoid
pressure points.
✓ Allow the c ast to set fully before providing p atient educ ation on c are and monitor ing.

Contraindic ations for Casting
✓ Open Fractures: Due to the r isk of infection, open fractures are t ypic ally managed with ex ter nal fixation or
surgic al inter vention rather than c asting LRobinson, 2020M.
✓ Severe Swelling: Casting in the presence of signific ant swelling c an le ad to complic ations like comp ar tment
syndrome. Initial tre atment with splinting is prefer red until swelling subsides LJohnson et al., 2019M.
✓ Infections: Skin infections or wounds at the site of c asting incre ase the r isk of complic ations and should be
resolved before applying a c ast.
✓ Circumferential Injuries: Injur ies with ex tensive swelling or circumferential involvement may require splinting
for e asier monitor ing and adjustments.
✓ Chronic Conditions: Patients with diabetes or vascular dise ase require special consideration due to an

incre ased r isk of delayed he aling and skin complic ations LSmith et al., 2022M.