Complications of Plaster Cast

Transcription

1 Complications of Plaster Cast Main complications of plaster are stiff joints, muscle wasting and impaired circulation. Physiotherapy and good nursing can help reduce these complications and speed the final recovery. Cast Complications Systemic Complications Deep Vein Thrombosis Muscle cramps Local Complications Immediate Delayed Complications of plaster cast can be divided in systemic, which affects whole body or local which affects limb where plaster has been applied. 1

2 Local complications of plaster can be further classified as immediate and delayed. Systemic Complications of Plaster Cast The most serious is deep venous thrombosis leading to pulmonary embolism. Pain in the calf is an important sign needing medical advice. Immediate Local Complications Plaster Cast A plaster produces constricting effect on the limb due to swelling of the part and most of it is well tolerated but a moderate constriction will produce compression of the veins, damming the blood, and causing swelling, pins and needles, discomfort or pain, and a blue color in the skin and under the nails. Temporary treatment such as elevation of the limb putting ice bags does helps but if persistent, the constriction must be relieved. The cast can be split and usually relives. Pale skin which is cool and without a palpable pulse indicates that the arterial supply is disrupted. If a pressure on the finger nail the color does not immediately return. This is a serious complication. Medical advice must be sought immediately. Incomplete arterial occlusion may present with pain or aching with loss of power. Delayed Local Complications of Plaster Cast Plaster Sores The most common cause of sores is pressure of the plaster on the skin. The patient may report burning, itching or stabbing pain. Patient might have disturbed sleep and elevated temperature. Development of plaster sore is painful. The patient is often able to pinpoint the sore area. It should not be ignored. 2

3 Loss of Position Because swelling occurs with most fractures especially after reduction, the technician puts padding under the cast to protect the skin. This padding gets compressed. After 48 hours when the swelling is subsiding, the cast may be too loose to hold the bone ends in position against undesirable muscle action. Such displacement may be sudden and cause pain or gradual being first noticed on the next x-ray. This complication may delay sound healing and may produce deformity. Nerve Damage Loss of power, tingling and numbness distal to the cast are signs of impaired nerve function. The cause may be direct compression by bone ends or plaster pressure, indirect compression of edematous tissue or reduced blood flow. Routine testing of power and sensation will detect any defect quickly. Corrective action includes relieving cast pressure, supporting and protecting paralyzed parts, and physiotherapy to help restore normal function of muscle and joints. Avoiding the Complications of Plaster Cast Follow the advice strictly and don t hesitate to ask questions Strict elevation and ice packs. 3

4 Report the pain which is not relieved, swelling, bluishness or pale colour. Keep the cast clean and dry. If there is any discharge or fever come to A&E Information you will need in case you need to contact for your queries Name of Consultant. Hospital number Date of Birth Date of injury Date of operation (if you already had operation. Contact you may need Any questions about follow up: Any medical questions: please call the hospital on and ask switch board to put you through the team looking after you (please see the numbers below) in case you don t remember please call on - Trauma co-ordinator : (Best is to contact the team as you might not get the answers you looking for from trauma co-ordinator) Northwick Park MR M BARTLETT (Hips and Knees) - Bleep 302 MR S JENNINGS (Hips and Knees) Bleep 302 4

5 MR J PEREZ Bleep 312 MR M SALA Bleep 308 Special interest in upper limb surgery Special interest in upper limb surgery Mr A R GUPTA (Hips and Knees) Bleep 315 MR AL-YASSARI Bleep 312 Special interest in upper limb surgery MR I HOLLOWAY (Hips and Knees) Bleep 302 MR J MURPHY surgery Bleep 315 Special interest in upper and lower limb MR L FREEDMAN Special interest in Knee surgery Bleep 315 MR G ALLARDICE Bleep 306 Special interest in Foot and Ankle surgery MR GIYAS BHATTEE (Hips and Knees) Bleep 311 MR K LEHDORFF Bleep 308 DR S BATTACHARYYA Ortho- Geriatrician Bleep 172 Central Middlesex Hospital Mr A R GUPTA (Hips and Knees) Bleep 315 MR J HOLLINGDALE Bleep 997 Special interest in Knees surgery 5

6 MR MICK PEARSE Bleep 997 MR K LEHDORFF Bleep 308 FEEDBACK ABOUT YOUR CARE These comments are very important for us because they tell us which factors are contributing to a good or bad experience for our patients. If there is any other information you think can be helpful on this leaflet please contact us on - sukhwinder.randhawa@nhs.net. If there is any complaint you would like to make as most medical care and treatment goes well, but things occasionally go wrong, and you may want to complain. So where do you start? Every NHS organisation has a complaints procedure. To find out about it, ask a member of staff, look on the hospital or trust's website, or contact the complaints department for more information. Officers from the Patient Advice and Liaison Service (PALS) are available in all hospitals. They offer confidential advice, support and information on health-related matters to patients, their families and their carers. In Northwick park Hospital PALS is located just on left next to elevators when you enter from mail entrance. In Central Middlesex hospital PALS is located just by the reception on left hand side. OUR SMOKE FREE POLICY Smoking is not allowed anywhere on our sites 6