OTC Orthopaedic Technologist Certified Upper Extremity Casting 2 — Questions and Answers
Question 1: When applying a short arm cast for a distal radius fracture, the wrist should typically be positioned in how many degrees of flexion?
- 0–5 degrees (neutral) (Correct answer)
- 15–20 degrees of flexion
- 30–40 degrees of flexion
- 45–60 degrees of flexion
Correct answer: 0–5 degrees (neutral)
A neutral or very slight flexion position (0–5 degrees) is standard for most distal radius fractures to minimize tendon strain and maintain reduction.
Question 2: Which complication is most directly indicated by a patient reporting a 'burning' sensation under a freshly applied cast?
- Compartment syndrome
- Thermal burn from exothermic reaction (Correct answer)
- Pressure ulcer formation
- Deep vein thrombosis
Correct answer: Thermal burn from exothermic reaction
Plaster of Paris generates heat during the exothermic setting reaction, and a burning sensation shortly after application suggests a thermal burn risk.
Question 3: For a long arm cast, the elbow is most commonly positioned at what angle?
- 45 degrees of flexion
- 90 degrees of flexion (Correct answer)
- 110 degrees of flexion
- Full extension (0 degrees)
Correct answer: 90 degrees of flexion
A 90-degree elbow flexion is the standard position for a long arm cast to balance functional use and fracture stability.
Question 4: Which type of stockinette is used directly against the skin before applying cast padding?
- Fiberglass mesh stockinette
- Cotton tubular stockinette (Correct answer)
- Elastic compression stockinette
- Foam-lined stockinette
Correct answer: Cotton tubular stockinette
Cotton tubular stockinette is applied first to protect the skin and provide a smooth base layer before cast padding and casting material.
Question 5: After applying a fiberglass cast, the orthopaedic technologist instructs the patient not to bear weight for how long until the cast reaches full strength?
- 5 minutes
- 30 minutes
- 2 hours (Correct answer)
- 24 hours
Correct answer: 2 hours
Fiberglass casts achieve handling strength quickly but require approximately 30 minutes to 2 hours to reach full weight-bearing strength.
Question 6: A 'sugar tong' splint applied to the forearm primarily prevents which motion?
- Wrist flexion and extension
- Forearm pronation and supination (Correct answer)
- Elbow flexion
- Finger abduction
Correct answer: Forearm pronation and supination
The sugar tong splint wraps around the elbow and forearm to restrict forearm pronation and supination while allowing some elbow motion.
Question 7: When padding a cast, extra padding layers are routinely added over which anatomical areas?
- The mid-diaphysis of long bones
- Bony prominences such as the radial and ulnar styloids (Correct answer)
- Muscle bellies with the most bulk
- Dorsal aspects of finger joints only
Correct answer: Bony prominences such as the radial and ulnar styloids
Bony prominences are at highest risk for pressure sores and must receive extra padding to prevent skin breakdown.
OTC Orthopaedic Technologist Certified Upper Extremity Casting 2
When applying a short arm cast for a distal radius fracture, the wrist should typically be positioned in how many degrees of flexion?