Application of cylinder cast (thigh to ankle)
CPT4 code
Name of the Procedure:
Application of Cylinder Cast (Thigh to Ankle)
Common names: Long-leg cast, Full-leg cast
Technical term: Femoro-crural cast
Summary
A cylinder cast from the thigh to the ankle is a plaster or fiberglass cast that immobilizes the leg from just below the hip to the ankle to allow for proper healing of fractures or injuries.
Purpose
This procedure addresses fractures, ligament injuries, or post-operative immobilization of the knee or lower leg. The goal is to stabilize the affected area, allowing bones or tissues to heal properly and preventing further damage or displacement.
Indications
- Fractures of the femur, tibia, or fibula
- Severe ligament injuries
- Post-surgical immobilization
- Congenital deformities requiring correction
- Chronic knee instability
Preparation
- No fasting required
- Inform the healthcare provider of any medications or allergies
- X-rays or MRI to assess the injury
- Examination to ensure no pre-existing infection or injury that could complicate casting
Procedure Description
- Positioning: The patient is positioned with the leg extended.
- Padding: Soft padding or stockinet is applied to protect the skin.
- Casting Material: Plaster or fiberglass materials are soaked in water to activate.
- Application: The wet casting material is wrapped around the leg, from thigh to ankle, ensuring even pressure and coverage.
- Molding: The cast is molded to the contours of the leg to provide secure immobilization.
- Drying: The cast material is allowed to set and harden, which can take several minutes to hours depending on the material used.
Tools Used: Bandage scissors, cast padding, plaster or fiberglass rolls, water bowl. Anesthesia/Sedation: Typically not required, though sedation may be used in highly anxious patients or young children.
Duration
The procedure typically takes about 30 to 45 minutes.
Setting
The procedure is usually performed in a hospital, outpatient clinic, or orthopedic office.
Personnel
- Orthopedic surgeon or physician
- Nurses or medical assistants
Risks and Complications
- Skin irritation or infection
- Compartment syndrome
- Circulation or nerve issues from too tight a cast
- Allergic reaction to casting material
- Delayed healing if cast is not properly set
Benefits
- Stabilizes fractures and injuries, promoting proper healing
- Reduces pain and discomfort by immobilizing the leg
- Prevents further injury or complications
Recovery
- Keep the cast clean and dry
- Elevate the leg to reduce swelling
- Follow-up appointments to monitor healing and adjust the cast if necessary
- Typical recovery period is 6-8 weeks, depending on the severity of the injury
Alternatives
- Functional brace or splint
- Surgical intervention with internal fixation
- Physical therapy without casting Pros and Cons: Braces and splints may offer more flexibility but less stability. Surgery may provide quicker recovery but carries surgical risks.
Patient Experience
- The patient might feel discomfort during the application, but pain should subside as the cast sets.
- Some heaviness and restriction in movement initially
- Ongoing low-level pain and itching can be managed with medications and proper care techniques