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Cast and splint application

Cast and splint application — external fixation of joints and bones for fractures, sprains, and post-surgical care.

External fixation method used to immobilize bones and joints in cases of fracture, dislocation, or soft tissue injury. It supports healing and reduces pain.

Indication

  • Closed bone fractures (arm, wrist, ankle, finger)
  • Joint sprains and ligament injuries requiring supportive fixation
  • Fixation after reduction of dislocations
  • Splinting for rest in selected tendon injuries
  • Fixation to protect healing after surgical repair
  • Pediatric fractures requiring child-appropriate light fixation

Preparation

  • X-ray evaluation of the injured area
  • Inspection of skin wounds and swelling
  • Removal of rings and tight accessories (to prevent circulation problems from swelling)
  • Skin is cleaned and dried

How it's performed

  1. The bone or joint is held in proper alignment (closed reduction is performed if necessary)
  2. Soft cotton padding is wrapped over the skin
  3. Wet plaster bandage or pre-formed splint material is applied in layers
  4. A splint or open cast is often preferred initially to allow for swelling
  5. The limb is kept still until the cast hardens
  6. Circulation, sensation, and movement at the fingertips are checked

Post-procedure

  • The limb is kept above heart level for the first 24-48 hours to reduce swelling
  • Fixation is generally maintained for 4-6 weeks (varies by fracture type)
  • Healing is monitored with follow-up X-rays
  • The cast or splint is removed by the physician
  • Physical therapy is provided afterwards for muscle strength and joint mobility

Risks

  • Compartment syndrome from swelling (pain, sensory loss, coldness — requires emergency evaluation)
  • Skin irritation, pressure ulcer, or itching
  • Infection under the cast (foul odor, fever)
  • Temporary joint stiffness and muscle weakness
  • Displacement of the fracture if fixation is improper or shifts

FAQ

How long does a cast or splint stay on?

Duration varies by fracture site and patient age; in most adult fractures 4-6 weeks of fixation is sufficient. The physician determines the duration individually based on follow-up X-rays.

What should I do if the cast gets wet?

Classic plaster casts soften when wet and may damage the skin. Cover the cast with a plastic protector during bathing. If it does get wet or develops odor, burning, or itching, consult your physician.

Which symptoms require urgent medical attention?

Increasing pain, bluish discoloration, coldness, sensory loss in the fingers; the cast feeling too tight or too loose; or fever and odor under the cast require emergency evaluation.

Will my joint return to normal immediately after the cast comes off?

Joint stiffness and muscle weakness are common. With controlled exercise and physical therapy when needed, function noticeably improves within a few weeks.