The joints at each end of the cast must be left free to mobilize during the period of casting. Avoid extending the cast too close to the elbow anteriorly (which prevents elbow flexion). Pay particular attention to leaving the metacarpophalangeal joints (MCPJs) free. Failure to do this will result in capsular contracture and loss of MCPJ flexion.
The patient should be encouraged to extend the fingers and make a fist many times daily.