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It is usually insured that the elbow remains immobilized in a slightly flexed position, usually around 90 degrees, to promote healing while maintaining comfort. Patients with long arm casts often require close monitoring for swelling and circulation issues, given the cast’s extensive coverage. Short arm thumb spica cast on a teenager
Initially, a backslab or a sugar tong splint is applied to allow swelling to expand and subsequently a cast is applied. [12] [5] Depending on the nature of the fracture, the cast may be placed above the elbow to control forearm rotation. However, an above-elbow cast may cause long-term rotational contracture. [5]
The elastic bandage is then applied to hold the splint in place and to protect it. This is a common technique for fractures which may swell, which would cause a cast to function improperly. These types of splints are usually removed after swelling has decreased and then a fiberglass or plaster cast can be applied.
Cutting the cast will reduce the intracompartmental pressure by 65%. [19] It will drop by 10 to 20% after cutting the padding. [19] After removal of the external compression the limb should be placed at the level of the heart. [50] The vital signs of the patient should be closely monitored.
The arm is usually supported by an external immobilizer to keep the joint stable and decrease the risk of further damage. The two most common types of fixation are the figure-of-eight splint that wraps the shoulders to keep them forced back and a simple broad arm sling (which supports the weight of the arm). The primary indication is pain relief.
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The Colles fracture is named after Abraham Colles (1773–1843), an Irish surgeon, from Kilkenny who first described it in 1814 by simply looking at the classic deformity before the advent of X-rays. [14] Ernest Amory Codman was the first to study it using X-rays.