Lower Extremity Cast Application.

This chapter will focus on lower extremity casting. Casting is widely recognized as the best treatment for many pediatric lower extremity fractures, unlike those in adults. Due to children's remodeling potential, the displacement threshold for surgery is often higher than that for skeletally mature patients, and immobilization in a cast with proper molding may be the only treatment needed.Lower extremity casts can be used to maintain the alignment of nondisplaced fractures. They are also utilized after closed reduction of a fracture, with appropriate molding to prevent any further displacement. Additionally, casts can provide protection and reinforcement following surgical fixation of lower extremity fractures.Proper casting technique is essential to prevent complications and ensure adequate fracture alignment. Cast treatment is not without risks and should not be considered benign. While it is less invasive than surgery, complications can arise after casting, some of which can be severe, such as compartment syndrome, burns, and significant pressure sores.In this chapter, 4 techniques for casting the lower extremities will be demonstrated: 1. Short leg cast 2. Long leg cast 3. Cylinder cast 4. Patellar tendon-bearing cast. Key Concepts: (1)Mastering casting techniques is crucial to avoiding significant complications.(2)A short leg cast can be used for lower leg and foot fractures.(3)Long leg casts are used to control rotational instability and manage distal femur, patella, and proximal tibia fractures.(4)Any patient's complaint of increased pain with a cast should be taken seriously and investigated.