Name of the Procedure:

Application of Long Leg Cast (Thigh to Toes); Walker or Ambulatory Type

Summary

A long leg cast is a type of casting that immobilizes the leg from the thigh down to the toes, allowing the patient to walk with the aid of crutches or other walking assistance. This is a common procedure to ensure proper healing of fractures or surgical repairs.

Purpose

The primary goal of applying a long leg cast is to stabilize and immobilize the lower limb to promote healing of fractures, corrective surgery, or severe soft tissue injuries. It provides structural support to the bones and joints while reducing pain and swelling.

Indications

• Fractures of the tibia or fibula
• Severe ligament or tendon injuries
• Post-surgical immobilization
• Correction of congenital deformities
• Extensive soft tissue injuries

Preparation

• Patients may need to undergo X-rays or other imaging studies to confirm the extent and specific location of the injury.
• It is important to inform the healthcare provider of any medications, allergies, or existing health conditions. Typically, fasting is not required.
• The skin should be clean and free of any lotions or creams before the cast is applied.

Procedure Description

1. The patient is positioned comfortably, with the injured leg elevated.
2. A stockinette is applied over the leg, from the toes to the upper thigh.
3. Padding material such as cotton or synthetic bandages is wrapped around to protect the skin.
4. Plaster or fiberglass casting material is moistened and wrapped around the leg in layers, from the foot up to the thigh.
5. The material is molded to fit the contours of the leg while maintaining proper alignment of the bones.
6. The cast is allowed to harden, forming a protective shell.
7. Once the cast is dry, the patient may be fitted with crutches or a walker for ambulation.

Duration

The entire procedure typically takes about 30 to 60 minutes.

Setting

This procedure is usually performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Orthopedic surgeon or a specialized healthcare provider
• Nurses or medical assistants for preparation and assistance

Risks and Complications

• Skin irritation or sores under the cast
• Swelling or circulation issues
• Compartment syndrome (rare but serious)
• Delayed healing or improper bone alignment
• Risk of blood clots

Benefits

• Ensures proper healing and alignment of bones and soft tissues
• Reduces pain and swelling by immobilizing the affected area
• Allows for partial mobility, aiding in a faster overall recovery

Recovery

• Follow specific instructions on keeping the cast dry and avoiding putting weight on the leg.
• Elevate the leg regularly to reduce swelling.
• Monitor for any signs of infection or complications, such as foul odors, excessive pain, or numbness.
• Follow-up appointments are critical to monitor healing progress and potentially remove the cast.

Alternatives

• Functional braces or splints
• Surgical fixation with metal rods, plates, or screws (for severe fractures)
• Physical therapy and rehabilitation programs

The choice of treatment depends on the specific nature of the injury, patient health, and activity level.

Patient Experience

• Mild discomfort and a feeling of heaviness initially may be experienced as the cast dries.
• Pain and swelling are typically managed with prescribed medications.
• It is important to follow all care instructions and attend follow-up appointments to ensure proper healing.