Orthopaedic Technologist Certified Cast Complications and Removal Flashcards

A patient with a long arm cast reports inability to extend the wrist and fingers. This finding is most consistent with compression of the:

Answer: Radial nerve at the lateral epicondyle

Inability to extend the wrist and fingers (wrist drop) indicates radial nerve compression, which commonly occurs at the level of the elbow under a long arm cast.

Cast itch (pruritus) should be managed by:

Answer: Blowing cool air into the cast with a hair dryer on cool setting

Blowing cool air into the cast with a hair dryer on the cool (not hot) setting is a safe method to relieve itching without risking skin injury.

When is it appropriate to cut a cast window?

Answer: To inspect or treat a wound beneath the cast

A cast window is cut to provide direct access to a wound for dressing changes or inspection without requiring full cast removal.

After cutting a cast window, the removed piece should be:

Answer: Replaced and secured to prevent 'window edema'

The cast window plug should be replaced and secured after each wound inspection to prevent localized swelling (window edema) in the exposed area.

A patient presents 3 weeks after cast application with a documented fracture that appears malaligned on X-ray. The MOST appropriate initial step is:

Answer: Notify the supervising physician

Fracture malalignment discovered during follow-up requires physician notification to determine whether reduction or surgical intervention is needed.

Which finding during neurovascular checks REQUIRES immediate physician notification?

Answer: Absent radial pulse in a newly casted forearm

An absent radial pulse indicates arterial compromise, which is a vascular emergency requiring immediate physician intervention.

The PRIMARY reason for applying a well-molded cast rather than a poorly fitting one is to:

Answer: Prevent fracture displacement and maintain reduction

A well-molded cast conforms to the limb's contours to maintain fracture reduction and prevent displacement during healing.