Name of the Procedure:

Cast supplies for a long arm cast, adult (11 years +), plaster (HCPCS Q4005)

• Common Names: Long arm cast, Plaster cast
• Technical/Medical Term: Immobilization cast, Plaster of Paris cast

Summary

A long arm cast, made specifically from plaster, is a type of medical cast that extends from the upper part of the arm to the wrist or fingers. It is used to immobilize and protect a broken arm or to facilitate the healing of certain arm injuries.

Purpose

This procedure is mainly used to:

• Provide stabilization for fractures of the forearm, elbow, or upper arm.
• Promote proper alignment and healing of broken bones.
• Alleviate pain by restricting arm movements.

Indications

• Bone fractures in the upper or lower arm.
• Injuries requiring immobilization for proper healing.
• Post-surgical stabilization of the arm bones.

Preparation

• No specific pre-procedure preparation is needed.
• Patients might be advised to wear loose-fitting clothing that can easily fit over the cast.
• Any diagnostic tests, like X-rays, should be completed beforehand to assess the severity of the bone injury.

Procedure Description

1. Assessment: The healthcare provider will assess the injury and ensure correct diagnosis using imaging tools like X-rays.
2. Preparation: The arm is positioned in the optimal alignment for healing.
3. Application:
   • The affected arm is covered with a cotton padding to protect the skin.
   • Plaster of Paris bandages are soaked in water and wrapped around the arm, shaping it appropriately.
   • The plaster hardens quickly to form a solid protective shell.
4. Final Adjustments: The provider may smooth out rough edges and ensure the cast fits securely but comfortably.

Duration

The procedure typically takes around 30 minutes to an hour.

Setting

This procedure is usually performed in a hospital, outpatient clinic, or an orthopedic surgeon’s office.

Personnel

• Orthopedic Surgeon or Physician
• Nurse or Medical Assistant

Risks and Complications

• Common: Skin irritation, itching under the cast.
• Rare: Compartment syndrome, cast sores, allergic reactions to materials, improper healing if the cast is not applied correctly.

Benefits

• Stabilization of the injury for effective healing.
• Pain reduction through immobilization.
• Expected to see bone healing within 6-8 weeks, though this can vary depending on age and health condition.

Recovery

• Post-procedure Care: Keep the cast dry and clean. Avoid inserting objects to scratch inside.
• Recovery Time: Typically 6-8 weeks, depending on the severity of the injury.
• Follow-Up: Regular check-ups to monitor healing progress. Cast removal is usually scheduled at one of these follow-ups.

Alternatives

• Splints or Braces: Less immobilization, used for minor fractures.
• Surgical Intervention: May be necessary for more severe fractures, followed by casting or splinting.
• Pros and Cons: Splints offer more flexibility but less protection; surgery can offer precise alignment but involves more risk and a longer recovery.

Patient Experience

• During: Patient likely to feel minimal discomfort but may experience the warm sensation as the plaster hardens.
• After: Initial period of adjustment to the cast. Some discomfort and itching might occur. Pain can be managed with over-the-counter or prescribed medications.

Pain and discomfort typically subside as the arm gets used to the cast, and normal activities can resume gradually based on medical advice.