“PREVENTION IS BETTER THAN CURE!”
A cast being applied too tightly, this may effect:
VEINS
– constriction will compress the walls of veins causing swelling, discomfort and pain.
The skin feels warm and looks blue and there is blue colour under their nails. Elevation of the
limb and exercise of the digits can be tried but the cast needs to be split or bi-valve.
ARTERIES
–
are usually involved due to the injury and not the cast.
In arterial
compression the limb will become pale and there will be paraesthesia. The limb will be cold
and pulses may be difficult to palpate. When pressure is applied to the finger nail, the colour
does not return. Immediate medical help must be obtained. Splitting the cast or bi-valving is
urgent.
NERVE COMPRESSION
– gives pins and needles sensation then limitation of movement and
pain, elevation and exercise may relieve this however if it persists after 20 mins of observed
exercise, medical advice should be sought.
INSUFFICIENT or inappropriate padding
– insufficient padding may not protect the skin. Too
much padding will rub up and crease inside the cast causing uneven pressure and discomfort.
UNEXPECTED excessive swelling
– will cause the same signs and symptoms as those
caused by a cast being applied to tight.
BANDAGES being applied with twisting or tension
– this will cause uneven pressure and
ridges in the cast which in turn may cause plaster sores
Pressure on superficial nerves and blood vessels
– As well as nerve compression,
pressure over superficial nerves may have serious consequences, for example: insufficient
padding over the head of the fibula may damage the lateral popliteal/ common peroneal nerve
causing foot drop
Plaster Sores
– Occur when skin presses directly onto bone. Foreign bodies inside the cast
will cause plaster sores, with children inserting small toys or coins into the cast
Cast Complications
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