The initial cast should either be a backslab or a split cast to allow for swelling.
Distal perfusion should be checked at all stages of this procedure and continually monitored after cast completion.
In most fractures, the cast is maintained for 4-6 weeks. Once the initial swelling has subsided, the cast is changed with careful maintenance of position. It may be prudent to obtain a check radiograph in the new cast to make sure that no displacement occurred as the cast was changed.