Application, cast; shoulder to hand (long arm)
CPT4 code
Name of the Procedure:
Application of a Cast; Shoulder to Hand (Long Arm)
Summary
In this procedure, a long arm cast is applied to immobilize the arm from the shoulder to the hand. This type of cast helps in stabilizing the entire arm for better healing of fractures or injuries.
Purpose
The procedure addresses fractures, dislocations, and severe injuries to the arm, elbow, and forearm. The goal is to immobilize the limb to promote proper bone healing and prevent further injury.
Indications
- Fractures of the humerus, radius, or ulna
- Severe sprains or ligament injuries in the elbow or wrist
- Post-surgical immobilization for healing
- Severe soft tissue injuries requiring stabilization
Preparation
- The patient may be advised to avoid food and drink if anesthesia will be used.
- Prior imaging studies like X-rays are required to assess the extent of the fracture or injury.
- The patient should inform the healthcare provider of any medications or allergies.
Procedure Description
- Assessment and Positioning: The patient's arm will be assessed and positioned correctly.
- Padding: Soft padding is applied to protect the skin and bony areas.
- Application: Wet cast material (fiberglass or plaster) is wrapped from the shoulder to the hand.
- Molding: The cast is molded to ensure proper fit and immobilization.
- Setting: The cast material is allowed to harden and set.
Tools and Equipment:
- Casting material (fiberglass or plaster)
- Padding material
- Water to activate the cast
- Scissors and tools to mold the cast
Anesthesia:
- Local anesthesia may be used if manipulating the bone is necessary.
Duration
The procedure typically takes about 30 to 60 minutes.
Setting
The procedure is usually performed in a hospital or outpatient clinic.
Personnel
- Orthopedic technician or nurse
- Orthopedic surgeon or physician assistant
- Possibly an anesthesiologist if sedation or local anesthesia is required
Risks and Complications
- Skin irritation or pressure sores
- Compartment syndrome
- Reduced circulation or nerve damage
- Allergic reaction to cast materials
Benefits
- Proper immobilization for optimal healing
- Prevention of further injury
- Stabilization for faster recovery
Improvement can usually be observed within a few weeks, but full healing often takes several months.
Recovery
- Keep the cast dry and clean.
- Avoid inserting objects into the cast.
- Elevate the arm to reduce swelling.
- Follow-up appointments for cast checks and potential adjustments.
Recovery time varies by the injury but typically ranges from 6 to 12 weeks. Physical therapy might be recommended.
Alternatives
- Removable braces or splints
- Surgical intervention with internal fixation
- Physical therapy alone for minor injuries
Alternative treatments may provide more mobility but may not ensure as rigid stabilization.
Patient Experience
During the procedure, patients may feel warmth from the setting cast material. Some discomfort may occur initially but usually subsides. Pain management may include over-the-counter pain relievers. Post-procedure, patients might experience itching, mild swelling, and adjustments in daily activities.