Information
- Loss of reduction
- Pressure necrosis, as early as 2 hours after cast/splint application
- Tight cast or compartment syndrome
- Univalving alone: 30% pressure drop
- Bivalving alone: 60% pressure drop
- Cutting of cast padding to further reduce pressure
- Use of “cast spreaders” in univalved casts minimizes contact pressure significantly.
- Thermal injury
- Avoid plaster thicker than 10 ply.
- Avoid water hotter than 24°C.
- Unusual with fiberglass
- Cuts and burns during cast removal due to poor technique
- Thrombophlebitis or pulmonary embolus: increased with lower extremity fracture and immobilization but prophylaxis debated. Upper extremity incidence may be up to 0.7%.
- Joint stiffness: Joints should be left free when possible (i.e., thumb MCP for short arm cast) and placed in position of function when not possible to leave free.