Orthopaedic Technologist Certified Cast Complications and Removal Questions and Answers

Question 1

A patient with a short leg cast for an ankle fracture complains of numbness and a "pins and needles" sensation on the top of their foot, along with difficulty lifting their toes toward their shin. Which underlying structure is MOST likely being compressed?

Accepted Answer

Peroneal nerve

Answer

The common peroneal nerve runs superficially around the neck of the fibula. A tight or poorly padded short leg cast can compress this nerve, leading to sensory deficits on the dorsum (top) of the foot and motor weakness of the ankle dorsiflexors, causing a condition known as "foot drop".

Question 2

Which of the following is the MOST significant factor contributing to thermal injury (burns) to the patient's skin during the application of a plaster cast?

Accepted Answer

Using water that is too hot to dip the plaster

Answer

The chemical reaction between plaster of Paris and water is exothermic, meaning it releases heat as it cures. Using water with a temperature greater than 24°C (75°F) dramatically increases the peak temperature of this reaction, significantly raising the risk of causing a thermal burn to the patient's underlying skin.

Question 3

To minimize the risk of cutting or burning the patient's skin, what is the proper technique for using an oscillating cast saw?

Accepted Answer

Using a series of short, repeated "in-and-out" pressing motions.

Answer

An oscillating saw blade vibrates rapidly back and forth; it does not spin. The correct technique is to press the blade perpendicularly into the cast until it cuts through, then lift it and repeat this motion along the cut line. This "in-and-out" or "press-and-lift" method prevents heat buildup from friction and avoids dragging the blade across the skin, which could cause an abrasion or burn.

Question 4

A patient in a hip spica cast for a femur fracture develops severe, cramping abdominal pain, persistent nausea, and bilious vomiting several days after application. These symptoms are MOST indicative of which serious complication?

Accepted Answer

Cast Syndrome (SMA Syndrome)

Answer

Cast syndrome, or Superior Mesenteric Artery (SMA) syndrome, is a rare complication where a large body or spica cast compresses the third portion of the duodenum between the SMA and the aorta. This creates a functional bowel obstruction, leading to symptoms of severe nausea, vomiting, and abdominal pain.

Question 5

When an Orthopaedic Technologist is instructed to bivalve a cast to relieve pressure, what is the correct procedure?

Accepted Answer

Making two complete longitudinal cuts on opposite sides of the cast.

Answer

Bivalving a cast means to cut it into two separate shells, typically an anterior and posterior half, by making two longitudinal cuts on opposite sides. This allows the cast to be spread or the top half to be removed completely, which fully relieves circumferential pressure while still allowing the bottom half to be used as a resting splint.

Orthopaedic Technologist Certified Test Practice Test

Orthopaedic Technologist Certified Test Practice Test

Orthopaedic Technologist Certified Cast Complications and Removal Questions and Answers