Aftercare following long leg cast application
The long leg circular cast is not intended to be a weight-bearing cast, so the patient will need to use crutches, or a walker. The leg should be kept elevated, whenever possible, to prevent additional swelling.
The exercises for the patient should be explained and demonstrated. These include: flexing the toes and lifting the leg.
A major concern with the use of a long leg cast for a distal femoral fracture is knee joint stiffness. Therefore, the duration of treatment in the long leg cast should be as short as possible (4-6 weeks). After this period, the cast will be changed to a hinged knee brace, or hinged knee cast to allow knee flexion and extension. This would be applied as soon as firm callus formation is present.
Weight bearing would be started at approximately 8-12 weeks following injury.
There should be regular radiological review until fracture union.
Consideration should be given to thrombo-embolic prophylaxis, according to local treatment guidelines.