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Application of short leg cast (below knee to toes)

CPT4 code

Name of the Procedure:

Application of Short Leg Cast
Common name(s): Below knee cast, Short leg cast
Technical term: Below Knee Plaster of Paris Cast Application

Summary

A short leg cast is a type of medical treatment where a plaster or fiberglass cast is applied to the lower half of the leg, extending from below the knee to the toes. It is primarily used to immobilize the lower leg after fractures, sprains, or surgeries.

Purpose

A short leg cast is used to immobilize the lower leg to facilitate healing and recovery.

  • Medical conditions addressed: Fractures, severe sprains, post-surgical stabilization.
  • Goals: Promote effective healing, reduce pain and swelling, prevent further injury.

Indications

  • Fractures of the tibia, fibula, ankle, or foot.
  • Severe sprains or ligament injuries in the ankle.
  • Post-operative care after lower leg or foot surgeries.
  • Immobilization for conditions like severe tendonitis or ulcers.

Preparation

  • Pre-procedure instructions: Come with clean skin, remove any jewelry, wear loose clothing.
  • Diagnostics: X-rays to confirm the nature and extent of the injury.
  • Medications: Stop any medications as advised by the healthcare provider.

Procedure Description

  1. Patient Positioning: The patient will typically sit or lie down with the leg elevated.
  2. Application:
    • Padding is applied around the lower leg for protection.
    • Wet plaster or fiberglass bandages are wrapped around the padding and molded to fit snugly.
    • The cast is allowed to dry and harden.
  3. Tools/Equipment: Plaster or fiberglass casting material, padding, water, scissors.
  4. Anesthesia: Usually, no anesthesia is required, though pain relief may be provided.

Duration

The entire procedure typically takes about 30-60 minutes.

Setting

A short leg cast is usually applied in a hospital, outpatient clinic, or emergency department.

Personnel

  • Healthcare Professionals Involved: Orthopedic surgeon or a trained orthopedic technician; sometimes a nurse or physician assistant.

Risks and Complications

  • Common Risks: Skin irritation, pressure sores, itching.
  • Rare Risks: Compartment syndrome, deep vein thrombosis, cast syndrome.
  • Management: Regular monitoring, cast adjustments, medication for pain or itching.

Benefits

  • Expected Benefits: Proper bone healing, decreased pain, increased mobility post-recovery.
  • Timeline: Benefits can start being recognized within the first week as pain and swelling reduce.

Recovery

  • Post-procedure care: Keep the cast dry and clean, avoid putting weight on the cast, elevate the leg.
  • Recovery time: Typically 4 to 6 weeks, depending on the injury.
  • Restrictions: Avoid walking on the cast unless directed, use crutches if needed.
  • Follow-up: Regular appointments for cast checks and potentially X-rays.

Alternatives

  • Other treatments: Splints, braces, or orthopedic shoes.
  • Comparison: Casts provide more rigid immobilization, which may be necessary for certain fractures; alternatives may offer more flexibility but less stability.

Patient Experience

  • During Procedure: Mild discomfort from the molding and drying process, cooling sensation from the wet plaster.
  • After Procedure: Initial heaviness, gradual adaptation; potential itching and mild discomfort managed with prescribed medication.

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