Stephen J. Schueler, M.D.

Overview Symptoms Evaluation Treatment Home Care warning signs Underlying Cause

Cast Pressure Evaluation

The evaluation of cast and splint problems includes:

  • Checking for normal blood flow to the hand or foot below the cast or splint
  • Checking for normal nerve function to the hand or foot below the cast or splint

Physical findings in those with cast and splint problems include:
  • Loss of sensation below the cast or splint
  • Moderate or severe pain when the examiner moves the patient's fingers or toes
  • Paleness or coolness of the skin of the fingers or toes
  • Severe swelling of the fingers or toes
  • Weakness of the fingers or toes

An additional sign of cast and splint problems includes delayed capillary refill

Instructions for testing capillary refill:
  • Pinch the nail against the finger or toe until the nail bed turns white.
  • Quickly release the nail.
  • The capillary refill is delayed if the nail bed remains white for more than 2 seconds.

Continue to Cast Pressure Treatment

Last Updated: Dec 7, 2010 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Cast Pressure References
  1. Ha Van G, Siney H, Hartmann-Heurtier A, Jacqueminet S, Greau F, Grimaldi A. Nonremovable, windowed, fiberglass cast boot in the treatment of diabetic plantar ulcers: efficacy, safety, and compliance. Diabetes Care. 2003 Oct;26(10):2848-52. [14514590]
  2. Haley CA, DeJong ES, Ward JA, Kragh JF Jr.Waterproof versus cotton cast liners: a randomized, prospective comparison. Am J Orthop. 2006 Mar;35(3):137-40. [16610379]
  3. Kadiyala RK, Waters PM. Upper extremity pediatric compartment syndromes. Hand Clin. 1998 Aug;14(3):467-75. [9742425]
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