Complications and complications may be encountered when wearing a cast

This is an automatically translated article.

The article was professionally consulted by Department of General Surgery & Anesthesia - Vinmec Hai Phong International General Hospital.

1. Complications of cast include what?

Casting is a kind of conservative treatment in trauma - orthopedics with many good effects. However, if the procedures and techniques of the fracture cast are not adequately prepared, complications after the cast are entirely possible.
1.1 Degrees of Complications After Casting Complications of Castings are divided into different degrees:
Mild: impairment or loss of limb function. Moderate: amputation. Severe: cause infection – systemic toxicity, leading to multiple organ failure and even death. 1.2 Causes of complications after casts Objective causes: due to initial infections and injuries. Subjective causes: the doctor's casting technique is not good, careless, ...

1.3 Complications of the cast Depending on the time, the complications of the cast can be divided into 3 main types:
Immediate complications
Severe pain, dizziness due to shock... during manipulation and cast. Shock or anaphylaxis due to anesthetics, anesthetics. There are signs of bronchospasm, reflux phenomenon... when the patient is anesthetized, it can cause respiratory arrest - cardiac arrest... leading to death. Early stroke
Damage to blood vessels, nerves...: For the upper extremities, some common injuries are in brachial artery, median nerve, radial nerve, ulnar nerve... For the lower extremities, popliteal artery, posterior tibial artery, common peroneal nerve... (rare). Cleft secondary to external bony protrusion. Break another bone, especially for elderly patients or people with bone and joint problems. Nutritional disturbances, edema, compression of the acute compartment cause limb necrosis... Myalgia and spinal fractures. Late complications
Subacute nutritional disorders or gradual nutritional disorders: causing prolonged swelling and stiffness, which can impair the function of the limbs, but not to the extent of limb necrosis. Subacute anemia and chronic anemia, causing fibrosis of the muscles. This is also Sudeck syndrome, Volkmann syndrome ... very difficult to treat and can not guarantee complete effectiveness, extremely expensive. Deviation: usually caused by the doctor's manipulation technique. Prosthetic joint: the patient is not properly immobilized, the doctor's manipulation technique is poor, due to age or due to the incorrect implementation of diet, exercise regime... throughout the time during and after the cast is broken. the bone . Osteoarthritis: is a complication from open fracture, ulcer, hematoma - infection...

How to handle post-cast complications according to the degree of
Mild: loosen the cast and elevate the cast limb. Moderate: manage in a mild manner with the addition of anti-edema, proximal block... Severe (with signs of compartment compression, vascular and nervous system damage... ): emergency surgery is required to treat each type of injury...

2. Some notes to remember after a cast fracture

In order to ensure the most favorable bone recovery process and minimize complications after the cast, patients need to note a few things:
Need to be re-examined immediately if abnormal signs appear: severe pain, swelling of the limb in a cast, signs of numbness and cyanosis at the tip of the finger, the pain is increasing... The cast limb should be prescribed higher to avoid edema. It is necessary to perform muscle stretching properly: the casted muscle area when inactive will atrophy and disrupt the recovery process of the bone, causing nutritional disorders. Therefore, it is necessary to help the muscles work by stretching. The limbs are not restricted (no cast), must exercise to promote blood circulation, avoid stiff joints.

Note, the dough needs at least 30 - 48 hours after the bundle to harden. Therefore, the patient should only move 2 days after the cast. If you travel earlier, the powder will be broken and the recovery effect will not be guaranteed. Wrap the powder in plastic wrap when going to the toilet or bathing, do not let the powder get wet because it will cause damage to the powder and foot odor. If the powder causes itchy feet or there is an attack from insects in the powder, absolutely do not use tools to poke - scratch ... because it will increase the risk of skin infection in the powder. In this case, the patient should notify the doctor for proper treatment. Re-examination on schedule. Casting fracture fracture is a simple and common procedure, but due to many reasons (possibly due to subjective, objective...) it is still likely to lead to complications of cast. Patients need to carefully monitor the condition of the body, especially the limb area, and immediately report to the doctor any abnormal signs.
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