General Editor: Chris Colton

Authors: Fergal Monsell, Dalia Sepulveda

Pediatric distal forearm 23u-E/2.1

Short or long arm cast

1. Introduction

This is a rare injury.

If there is diagnostic doubt, screening by image intensification can be useful.

2. Short arm cast

General considerations

The majority of these fractures can be managed with a short arm cast. The operator should determine the stability of the fracture. If it is unstable with a tendency to displace a long arm cast is preferred. The purpose of the cast is to provide symptomatic relief during the period of fracture healing.

Splitting the cast

If a complete cast is applied in the acute phase after injury, it is safer to split the cast down to skin over its full length.

The cast may be split along the ulnar border or radially according to surgeon preference and/or the presence of any associated soft tissue compromize.

3. Long arm cast

General considerations

A long arm cast should always be used where it is necessary to control forearm rotation in order to prevent fracture displacement. In very young and in noncompliant children, a long arm cast is preferable even if a short cast would otherwise be appropriate

The long arm cast is applied according to standard procedure:

Splitting the cast

If a complete cast is applied in the acute phase after injury, it is safer to split the cast down to skin over its full length. The cast may be split along the ulnar border or radially according to surgeon prefernece and/or the presence of any associated soft tissue compromize.

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v1.0 2016-12-01