Name of the Procedure:

Application of Rigid Total Contact Leg Cast

Summary

A rigid total contact leg cast is a specialized type of cast used to immobilize the leg for proper healing. It is molded to the contours of the leg to provide maximum support and reduce swelling.

Purpose

This procedure is often used to treat fractures, ulcers, or severe sprains. The goal is to immobilize the leg to promote proper alignment and healing while simultaneously reducing swelling and preventing further injury.

Indications

• Fractures of the tibia or fibula
• Severe sprains
• Diabetic foot ulcers
• Charcot foot
• Post-surgical care Patient criteria:
• Those with conditions that require immobilization of the leg
• Patients who can tolerate a non-removable cast

Preparation

• Pre-procedure instructions may include fasting if anesthesia is used.
• Patients may need to adjust medications as advised by their healthcare provider.
• Diagnostic tests such as X-rays or MRIs to assess the injury.

Procedure Description

1. The patient’s leg is cleaned and dried.
2. A cast liner or padding is applied to protect the skin.
3. The casting material (often fiberglass or plaster) is soaked in water.
4. The wet casting material is wrapped around the leg, molded to fit the contours.
5. The cast is allowed to dry and harden.
6. Any necessary adjustments are made to ensure proper fit.

Tools and Equipment:

• Cast liner
• Plaster or fiberglass casting material
• Scissors or other cutting tools

Anesthesia:

• Usually not required, but regional anesthesia may be used in some cases.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

The procedure is usually performed in a hospital, outpatient clinic, or doctor's office.

Personnel

• Orthopedic surgeon or specialist
• Nurse or medical assistant
• Possibly an anesthesiologist if sedation is required

Risks and Complications

Common Risks:

• Skin irritation or breakdown
• Swelling
• Discomfort or pain Rare Complications:
• Compartment syndrome (increased pressure within muscles)
• Cast sores or ulcers

Management:

• Regular monitoring and adjustments to the cast as needed

Benefits

• Proper immobilization for optimal healing
• Reduced swelling
• Protection from further injury
• Benefits usually realized shortly after application, with full healing over several weeks.

Recovery

• Follow-up appointments for cast adjustments or removal, typically in 4 to 8 weeks.
• Keep the cast dry and clean.
• Monitor for signs of complications like increased pain, swelling, or changes in sensation.
• Limited weight-bearing or activity as instructed by your healthcare provider.

Alternatives

• Removable brace or splint
• Soft cast
• Surgery, in some cases Pros and Cons:
• Removable options may provide less support but offer easier hygiene.
• Surgery may be necessary for more severe injuries but comes with its own risks and longer recovery.

Patient Experience

During the procedure:

• The patient may feel warmth as the cast sets.
• Minimal discomfort is expected. After the procedure:
• Initial tightness or snugness.
• Some discomfort or itching, especially as swelling decreases. Pain Management:
• Over-the-counter pain relievers usually suffice.
• Elevation and ice (applied indirectly) can help reduce swelling and discomfort.