Page 121 - ASOP Orthopedic Casting Manual

Introduction: Purpose

and Importance of

Casting for the Lower

Extremity

Or thopedic c asting for the lower ex tremit y is a fundamental inter vention in the management of fractures, soft
tissue injur ies, and post-surgic al immobilization. The lower ex tremit y consists of complex anatomic al structures,
including bones, joints, muscles, and ligaments, that play a vital role in weight-be ar ing and mobilit y. When an
injur y occurs, maintaining proper alignment and stabilit y is cr itic al for he aling and functional recover y. Casting
ser ves as a non-invasive me ans of immobilization, allowing for controlled he aling while minimizing the r isk of
complic ations such as malunion, nonunion, or joint contractures. Additionally, lower ex tremit y c asts help reduce
p ain and inflammation by restr icting unnecessar y movement at the injur y site. Clinicians must consider factors
such as the t ype and sever it y of the injur y, the p atient's activit y level, and the need for p ar tial or full weight-
be ar ing restr ictions when selecting the most appropr iate c asting method.
Beyond immobilization, c asting plays a crucial role in preventing secondar y complic ations associated with
musculoskeletal injur ies. A proper ly applied c ast ensures adequate suppor t and stabilit y while maintaining
circulation and soft tissue integr it y. However, improper applic ation, excessive tightness, or prolonged
immobilization c an le ad to severe complic ations such as pressure ulcers, skin maceration, ner ve compression,
and deep vein thrombosis LDVTM. Special attention must be given to bony prominences, vascular structures, and
soft tissue p adding to prevent excessive pressure that could compromise skin and neurovascular he al th.
Additionally, clinicians must educ ate p atients on proper c ast c are, including monitor ing for signs of comp ar tment
syndrome, infection, or c ast loosening. Regular follow-up and c ast adjustments, if necessar y, are essential to
ensure continued effectiveness and prevent complic ations dur ing the he aling process.
The effectiveness of lower ex tremit y c asting also ex tends to its imp act on rehabilitation and long-ter m function. A
well-constructed c ast allows for safe he aling while preser ving joint mobilit y and reducing the r isk of muscle
atrophy. In c ases of prolonged immobilization, weight-be ar ing restr ictions must be c arefully managed to prevent
muscle deconditioning and loss of propr ioception. Additionally, rehabilitation protocols, including gradual weight-
be ar ing progression and range-of-motion exercises, should be incor porated as p ar t of the recover y plan to
ensure a smooth transition from immobilization to functional movement. Understanding the biomechanics of the
lower ex tremit y and selecting the most appropr iate c asting technique—such as shor t leg c asts, long leg c asts, or
walking c asts—c an signific antly imp act the p atientʼs recover y trajector y. By master ing best practices in lower
ex tremit y c asting, he al thc are providers c an optimize p atient outcomes, reduce complic ations, and enhance the
overall success of or thopedic tre atment.