Name of the Procedure:

• Common Name: Pediatric Gauntlet Cast
• Technical/Medical Term: Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass (HCPCS Code: Q4016)

Summary

A pediatric gauntlet cast using fiberglass is a specialized cast applied to children aged 0-10 years to immobilize the lower forearm and hand. This type of cast helps heal fractures or other injuries by keeping the affected area stable.

Purpose

• Medical Conditions: Used to treat fractures, severe sprains, and some types of skeletal deformities in the lower forearm and hand.
• Goals: To stabilize the bone or injury, promote proper healing, and reduce pain and swelling.

Indications

• Symptoms: Swelling, bruising, severe pain, and inability to move the forearm or hand.

• Conditions: Simple or complex fractures of the lower forearm or hand, severe sprains, and post-surgical immobilization.

  Preparation

• Pre-Procedure Instructions: Generally, no fasting is required. Patients should inform their healthcare provider about any medications they are taking.
• Pre-Procedure Assessments: An X-ray or MRI may be required to assess the injury's extent.

Procedure Description

1. Assessment: Initial evaluation and imaging to determine the exact nature of the injury.
2. Preparation: The affected area is cleaned and, if necessary, padded.
3. Application:
   • Apply a cotton or synthetic lining to the forearm and hand.
   • Roll out layers of fiberglass material, molding it to fit the contour of the limb.
   • Allow the material to harden, forming a rigid cast.
4. Final Examination: The cast is checked for comfort and proper fit.

• Tools: Padding material, fiberglass rolls, water (to activate fiberglass), and shears (to trim excess material).
• Anesthesia/Sedation: Usually not required, but a mild sedative or local anesthetic may be used for very anxious children.

Duration

The procedure typically takes about 30-45 minutes.

Setting

• Performed in a hospital, outpatient clinic, or specialized casting room.

Personnel

• Orthopedic technician or nurse
• Physician, usually an orthopedic specialist
• Radiologic technician (for imaging)

Risks and Complications

• Common Risks: Skin irritation, pressure sores, itching under the cast.
• Rare Risks: Compartment syndrome, cast-related infections, or poor alignment requiring readjustment.

Benefits

• Expected Benefits: Proper immobilization promoting effective and faster healing of the injury. Relief from pain and swelling and reduced risk of further injury to the area.
• Time Frame: Benefits are realized almost immediately as immobilization helps to reduce pain and stabilize the injury.

Recovery

• Post-Procedure Care: Keep the cast dry, avoid inserting objects to scratch inside the cast, attend follow-up appointments.
• Recovery Time: Typically 4-6 weeks, depending on the injury's severity. Limit high-impact activities until clearance from a medical professional.

Alternatives

• Other Options: Splints, removable braces, or soft casts.
• Comparison: Alternatives may offer more flexibility but are typically less effective at immobilization compared to a fiberglass cast.

Patient Experience

• During Procedure: The child might feel slight warmth as the fiberglass hardens.
• Post-Procedure: Some discomfort initially, which can be managed with pain relievers. Encouragement and support can help children adapt to the cast.