Name of the Procedure:

Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster (HCPCS Code: Q4013)

Summary

A gauntlet cast is a type of plaster cast specifically designed to immobilize the lower forearm and hand. It is commonly used to treat fractures, severe sprains, or other injuries in this region. The cast keeps the affected area stable, allowing bones and tissues to heal properly.

Purpose

The primary goal of a gauntlet cast is to immobilize the lower forearm and hand to facilitate proper healing of fractures, sprains, or other injuries. By restricting movement, the cast helps align bones, reduce pain, and prevent further injury.

Indications

• Fractures of the lower forearm or hand
• Severe sprains and ligament injuries
• Post-surgical immobilization to protect repairs
• Chronic conditions like arthritis that require immobilization

Preparation

• The patient should wear comfortable, loose-fitting clothing that can accommodate the cast.
• Any existing injuries will be assessed using X-rays or similar diagnostic tools.
• The area may be cleaned and prepped to ensure optimal cast adhesion.

Procedure Description

1. Assessment: The healthcare provider assesses the injury and plans the cast application.
2. Positioning: The patient's forearm and hand are properly positioned.
3. Padding: Soft padding is applied to protect the skin and provide comfort.
4. Plaster Application: Plaster strips are soaked in water and wrapped around the forearm and hand, starting from just below the elbow down to the fingers.
5. Smoothing: The plaster is smoothed out and molded to ensure a snug fit.
6. Drying: The plaster is allowed to dry and harden, which usually takes about 15-20 minutes.

Duration

The entire procedure typically takes around 30 to 45 minutes.

Setting

The procedure is usually performed in an outpatient clinic, emergency room, or hospital setting.

Personnel

• Orthopedic specialist or general provider
• Nurse or medical assistant
• Radiologist (for diagnostic imaging, if needed)

Risks and Complications

Common risks include:

• Skin irritation or sores
• Swelling and discomfort
• Stiffness or reduced mobility after cast removal

Rare complications may include:

• Compartment syndrome (increased pressure within muscles)
• Blood clots
• Delayed or improper bone healing

Benefits

• Proper immobilization speeds up the healing process
• Reduces pain and discomfort by stabilizing the injury
• Decreases the risk of further injury

Recovery

• Keeping the cast dry and clean is essential.
• Elevating the limb can reduce swelling.
• Follow-up appointments will ensure the injury is healing correctly.
• The cast is usually worn for 4-6 weeks, depending on the injury.
• Physical therapy may be recommended to restore strength and flexibility.

Alternatives

• Splints or braces, which provide similar immobilization but are removable.
• Surgery, in cases where immobilization alone is not sufficient.
• Functional braces, allowing limited movement while providing support.

Pros and Cons of Alternatives:

• Splints/braces: Less restrictive but may offer less protection.
• Surgery: Provides precise repair but involves surgical risks.
• Functional braces: Allow for limited activity, suitable for less severe injuries.

Patient Experience

• During the procedure, the patient may feel pressure as the plaster is applied.
• After the cast hardens, there might be a sensation of tightness.
• Pain management, if needed, could involve OTC pain relievers or prescribed medication.
• Patients should be aware of signs of complications, like increased pain, swelling, or numbness, and seek medical attention if they occur.