long arm cast indications

Apply 2 or 3 layers of Webril over the area to be splinted. Water Scoop Operating Lever Fulcrum A cast iron support fastened on a tender frame and holding a bolt or pin that passes through the water scoop operating lever. Medial physeal clavicle fractures Precautions 1. Technique Application Cast from the mid- Humerus to the distal palmar crease (volar) and proximal to MCPs (dorsal) Position Elbow flexed to 90 degrees Wrist slightly extended V. Precautions Apply extra padding over the olecranon and antecubital fossa, as well as the ulnar styloid Theddy Slongo is presenting an interactive webinar about casting in children discussing indications and techniques. Fractures of the humerus (upper arm) are treated either with a sling or a brace, but not a cast. The treatment of pediatric supracondylar humerus fractures. The decision to apply a splint rather than a cast requires several . The posterior mold is overwrapped with one layer of web roll to prevent adherence to the next layer. Indications Distal Radius and Ulna Fracture III. Delbit cast - for fracture of tibia or fibula. For more information and videos, please visit http://global-help.org and http://www.pedortho. Be generous, avoid wrinkles, and place extra padding around bony prominences. The sugar tong is overwrapped with one layer of web roll to prevent circumferential immobilization once the posterior mold is applied, which would not allow for expansion. 7th ed. J Am Acad Orthop Surg. [Level 5]. See something you could improve? 1. Apply the stockinette so that it extends 2 or u0003 3 inches beyond the fiberglass. Dittmer AJ,Molina D 4th,Jacobs CA,Walker J,Muchow RD, Pediatric Forearm Fractures Are Effectively Immobilized With a Sugar-Tong Splint Following Closed Reduction. The Sugar Tong Orthosis consists of a long and narrow thermoplastic rectangle. Walthall J, Adame JD, Varacallo M. Long Arm Splinting. This type of splint provides immobilization to the elbow and the wrist. Indications Unstable fractures require a long arm cast to control forearm rotation and therefore decrease the risk of displacement. Cylinder/stovepipe cast. Preparing and applying splint. Ojeaga P, Wyatt CW, Wilson P, Ho CA, Copley LAB, Ellis HB Jr. Pediatric Type II Supracondylar Humerus Fractures: Factors Associated With Successful Closed Reduction and Immobilization. Patient monitoring after splint placement is recommended. Keep dirt and sand away from the inside of your child's cast. Unlike casts, which are circumferential, splints are often the treatment of choice in the emergency department (ED) because they allow for swelling that may be present at the site of injury and thereby decrease the risk of compartment syndrome. The long arm cast is one of the easier casts to learn when doing upper extremity casting. She was noted to have significant loss of alignment especially on the lateral view. [QxMD MEDLINE Link]. In this kind of traction, a device circles the head and attaches to a harness that's worn like a vest around the torso. Thiscan helpwith the accurate placement of materials and minimize impingement of structures that could otherwise need to be adjusted after splint application (e.g., anterior cubital fossa). [QxMD MEDLINE Link]. Reichman EF, ed. Elvis's identical twin brother, Jesse Garon Presley, was delivered 35 minutes before him, stillborn. The indications for splinting are broad, but commonly include: Temporary stabilization of acute fractures, sprains, strains or nerve injuries before . (This is . Typically, a long arm splint is the initial form of immobilization. 1 Background; 2 Indications; 3 Contraindications; 4 Equipment; 5 Preparation; 6 Anatomy; 7 Technique; 8 Aftercare; 9 Complications; 10 See Also; 11 References . Basic Clin Pharmacol Toxicol. Matsumoto MA, De Oliveira A, Ribeiro Junior PD, Nary Filho H, Ribeiro DA. Feel free to get in touch with us and send a message. (Orthop edic consults are needed for supracondylar fractures) DIMENSIONS Width to cover the arm circumference. Three weeks after the physician placed a long arm cast on Jeff, he was skateboarding and crushed the cast (without further injury to the arm). For plaster and fiberglass, the length of the sugar tong and posterior splint should be pre-measured. Splints are often called half casts because they don't fully surround an injured area. After spasticity has been diminished by neurolytic or surgical techniques, the elbow is casted in maximum extension. Metacarpal head fracture - emergency management. Excessive immobiliza- tion from continuous use of a cast or splint can lead to chronic pain, joint stiffness, muscle atrophy, or more severe complications (e.g., complex regional pain syndrome). 2008 Jan. 16 (1):30-40. Indications Distal humerus fracture Olecranon fracture Proximal radius and ulna fractures Elbow dislocation (after reduction) Contraindications A long arm cast prevents the forearm from rotating to keep bones stable while healing. Long arm splints are used in a variety of settings for immobilization of both bony and soft tissue injuries to the upper extremities. Available At Http://Hubpages.Com/Hub/Cast . [QxMD MEDLINE Link]. J Bone Miner Res. Indications of Splinting. . 13.5 ). J Pediatr Orthop. [Full Text]. | Lisa Jacobson, MD Attending Physician, Department of Emergency Medicine, Washington Hospital Center Splints that are wrapped too tight can lead to patient discomfort and possibly decrease perfusion to the extremity. When would you use a collar and cuff sling? Thumb spica cast. ace wraps), Reassess distal pulse, motor, and sensation. Also, fiberglass application often requires the tighter application of a compressive dressing which can cause discomfort to patients if it is not loosened. INDICATIONS: The patient is a 78-year-old male with a history of anemia, and lung carcinoma. Measuring plaster. This position has caused the highest degree/intensity of pain since the injury occurred and continues to cause pain & discomfort in the cast. Leave adjustments to your child's doctor. You are currently viewing the original 'fpnotebook.com\legacy' version of this website. On the other hand, fiberglass is more durable with higher fatigue resistance; however, it is more difficult to mold and does not mold to a patient's anatomy as closely. Posterior long arm splinting. Use a generous amount of padding on the arm to prevent discomfort in the axilla. Plastic and reconstructive surgery. Anasthesie, Intensivtherapie, Notfallmedizin. This heat can cause patient discomfort. She was noted to have significant loss of alignment especially on the lateral view. Explain the main biomechanical principles of cast fixation. Tighten the straps to keep your hand and forearm elevated above the level of your elbow. After the cast is removed, the skin may be dry and itchy. INDICATIONS l Olecranon fractures l Humerus fractures l Radial head and neck fractures CONSTRUCTION l Start at posterior proximal arm l Down the ulnar forearm l End at the metacarpophalangeal joints APPLICATION l Cut hole in stockinette for thumb l Elbow at 90 l Forearm neutral position with thumb up l Neutral or slightly extended wrist (10-20) INDICATIONS l Soft tissue injuries of the . 2019: Pensive. paperless employee login manpower. Erik D Schraga, MD Staff Physician, Department of Emergency Medicine, Mills-Peninsula Emergency Medical AssociatesDisclosure: Nothing to disclose. Recognize the difference between conventional plaster of Paris and fiber casting tape. Several indications exist for short arm splinting. This keeps blood and fluid from pooling in your hand and wrist. 9th ed. Chow YC, Lee SW. Elbow and forearm injuries. 2016 Sep 16 [PubMed PMID: 27638495], Lee SK,Kim KJ,Cha YH,Choy WS, Conservative Treatment Is Sufficient for Acute Distal Radioulnar Joint Instability With Distal Radius Fracture. - Indications: - used for comminuted humeral frx - disatl humeral shaft frx; - cast must be light wt. Links. Splinting also alleviates extremity pain and edema and promotes soft-tissue and bone healing. 20 (5):320-7. Finally, an elasticbandage is wrapped over the splint materials beginning distally and ending proximally. Review the complications of a long arm splint. Cardiac cath is performed to find out if you have disease of the heart muscle, valves or coronary (heart) arteries. You are being redirected to A long arm cast is used for fractures of the upper forearm, the elbow, and after elbow surgery. The practitioner needs to take time to become familiarwith the materials and techniques needed to make a well-padded and molded splint that properly positions a patient to maintain a reduction and allow for soft tissue swelling. Roberts and Hedges Clinical Procedures in Emergency Medicine and Acute Care. 951-70. Excessive immobilization from continuous use of a cast or splint can lead to chronic pain, joint stiffness, muscle atrophy, or more severe complications (e.g., complex regional pain syndrome).. Risks and Contraindications There are no long-term risks associated with traction. 1982 Dec; [PubMed PMID: 6818867]. This . POSTOPERATIVE DIAGNOSIS: Same OPERATION: Closed manipulation or closed osteoclasis, left distal radius fracture and application of a long-arm fiberglass cast. Collar and cuff is a type of sling commonly used for injuries to the arm. For pediatrics, 2-inch sugar tong and posterior mold often work well. International orthopaedics. Boyd A, Benjamin H, Asplund C. Splints and casts: indications and methods. Double hip spica cast Anticipate the major risks and complications of casting. Avoid placing powder, lotion or deodorant on or near the cast. 04. After a splint is placed, follow-up for definitive care with an orthopedist should occur within 1-5 days. Indications for operative management include: Displacement greater than 1mm An intrascaphoid angle greater than 35 degrees (humpback deformity) A radiolunate angle of more than 15 degrees Transcaphoid perilunate dislocation Proximal pole fractures Comminuted fractures Indications. The practitioner may decide on the width of plaster or fiberglass to use that best fits the patient's anatomy. WOUND CLASSIFICATION: Clean OPERATIVE . Plaster can cause skin irritation if it makes direct contact with the skin. In this case, a sugar-tong splint, a long arm splint, or a long arm cast should be considered. Is Bone Mineral Density Testing Underused in Prostate Cancer Care? The below videos are taken from the AO Publication "Casts, Splints, and Support Bandages - Nonoperative treatment and perioperative protection" edited by Klaus Dresing, Peter Trafton, and Jos Engelen. Please confirm that you would like to log out of Medscape. The long arm cast. [QxMD MEDLINE Link]. The first casting bandage follows. Variations of short arm casts are used for specific injuries (eg, thumb spica cast for scaphoid fractures). Although access to this page is not restricted, the information found here is intended for use by medical providers. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTM1NTExMC1vdmVydmlldw==, Injuries associated with neurovascular compromise. This publication examines the principles, methods, and techniques for applying a modern plaster or synthetic cast for the treatment of fractures, ligament, nerve, and soft-tissue injuries, overload injuries, and infections. Materials used should contour bony prominences, and care should be taken to mold the splint in the desired position of immobilization.[4][5][6][7]. . Background Posterior long arm splinting is used in the management of multiple upper-extremity injuries. indications first line of treatment technique arm immobilized in pronation and slight radial deviation Operative ECU subsheath reconstruction +- wrist arthroscopy indications if nonoperative management fails technique direct repair in acute cases chronic cases may require a extensor retinaculum flap for ECU subsheath reconstruction Recent upper GI series revealed some deformity of the duodenal bulb. Assessment of Splints Applied for Pediatric Fractures in an Emergency Department/Urgent Care Environment. A long arm cast is the most commonly used static orthosis for positioning the elbow ( Fig. 21. Moraleda L, Valencia M, Barco R, Gonzlez-Moran G. Natural history of unreduced Gartland type-II supracondylar fractures of the humerus in children: a two to thirteen-year follow-up study. Photos with arm casts and leg casts. 2016 Sep; [PubMed PMID: 27525497], Sofu H,Gursu S,Camurcu Y,Yildirim T,Sahin V, Pure elbow dislocation in the paediatric age group. Jump to: navigation, search. Complete history and physical is as per consultation note. Duration: 5-6 weeks. Identify those fractures which are suitable for conservative treatment. A cast applied in the period immediately following injury, should be adequately padded and split longitudinally. Halanski M, Noonan KJ. Vaishali Patel, MD Assistant Clinical Professor, Co-director of Quality Assurance/Continuing Quality Improvement, Department of Emergency Medicine, Mount Sinai School of Medicine; Consulting Staff, Department of Emergency Medicine, Mount Sinai Medical Center; Director of ED PAs, Department of Emergency Medicine, Mount Sinai Medical CenterDisclosure: Nothing to disclose. PROCEDURE: COLONOSCOPY: The colonoscope was advanced into the cecum. During the curing process, splinting materials give off heat in an exothermic reaction. 2019 Nov. 98 (46):e17973. The cast is applied. This activity presents the indications for a long arm splint and highlights the role of the interprofessional team in the management of patients with arm pathology. [QxMD MEDLINE Link]. Typically, a long arm splint is the initial form of immobilization. Hand (New York, N.Y.). 1809-20. Wearing a bent-knee leg cast may temporarily change your lifestyle, but it needn't immobilize you. J Bone Joint Surg Am. I'm unable to tolerate pain medication, so I take 600mg of ibuprofin every 6 hours. Excessive immobilization from continuous use of a cast or splint can lead to chronic pain, joint stiffness, muscle atrophy, or more severe complications, such as complex regional pain syndrome. Check out the new My Emergency Department app - a single source of truth for all your ED team's guidelines, policies and education content. She was seen in our office today 1 week after being placed into a cast for a displaced fracture. The benefit of plaster as a splint medium is that it conforms more precisely to the patient's anatomy; however, it lacks fatigue strength compared to fiberglass. Internet Explorer 8.0 and older will automatically be redirected to this legacy version. Long arm splints are often used to immobilize and support forearm and elbow injuries.. EBSCOhost Login . Apply sling to arm. When Your Leg Is in a Cast, You Need a Sense of Humor and Lots of Patience! Pull the strap around the back of your neck and push it through the loop near your hand. Long arm casts - extend from the axillary fold to the proximal palmer crease. You can adjust to the limitations it imposes and may even acquire a new level of patience from the experience. 2015 Jan [PubMed PMID: 24787302], Page MJ,Massy-Westropp N,O'Connor D,Pitt V, Splinting for carpal tunnel syndrome. Upper-extremity injuries for which posterior long arm splinting is indicated include the following Halanski MA, Halanski AD, Oza A, Vanderby R, Munoz A, Noonan KJ. Jessica Freedman, MD Assistant Professor, Department of Emergency Medicine, Mount Sinai School of Medicine; Consulting Staff, Department of Emergency Medicine, Mount Sinai Hospital [QxMD MEDLINE Link]. Long arm cast . Some have Velcro straps which make . Explain the principles of cast application. Cast brace - for fracture of femur (distal curve) with flexion and extension. This technique can be used to immobilize joints of the hand and wrist or to protect bony and soft tissues in the forearm. Are Children With Atopic Dermatitis More Likely to Fracture Bones? Posterior long arm splinting. Casts are solid dressings applied to a limb or other body part. If you log out, you will be required to enter your username and password the next time you visit. An interprofessional team consisting of emergency physicians, orthopedists, and emergency or orthopedic nurses will improve care and outcomes. Radial head fracture (although a simple sling is preferred in most settings), Capitellum fractures (if significant swelling present), Elbow fracture/dislocations (after the appropriatereduction is achieved), Monteggia fracture/dislocations --the Monteggia eponym implies a proximal ulna fracture with an associated radial head dislocation, A useful eponym for emergency medical personnel is the term "MUGR" (pronounced "MUGGER"), In most clinical situations, a simple sling provides enough patient comfort/immobilization, collateral ligament injuries/UCL injuries. 2012 Jul 11 [PubMed PMID: 22786532], Smoot EC, Long arm splinting of the pediatric upper extremity. J Mol Histol. indications unstable patterns unable to reduce initially, or with loss of reduction in cast at follow-up Salter-Harris I or II fractures in the setting of neurovascular (NV) compromise CRPP reduces need for tight casting in setting with increased concern for compartment syndrome New York: McGraw-Hill; 2019. Wet the fiberglass and place it over the . Care should be taken to stop the material approximately 1 cm short of the distal web roll to allow for an adequate bumper for soft tissues in the hand and not to restrict metacarpal phalangeal joint motion. Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference. Minimally displaced clavicle shaft fractures 2. Potential complications Failure (reduction or immobilisation) Thermal burns (from heat released during setting of plaster) Neurovascular compromise Pruritis Dermatitis Abrasions and pressures sores (with risk of infection) Joint stiffness Procedural hygiene Standard precautions PPE: non-sterile gloves, apron Area Plaster room or bed space Staff For example, the patient with elbow pain in which no obvious fracture is seen but a joint effusion is present as evidence by an enla rged posterior fat pad. Reduced COX-2 expression in aged mice is associated with impaired fracture healing. Indications Long arm splints have a variety of indications: Distal humerus fractures Olecranon fractures Radial head fracture (although a simple sling is preferred in most settings) Capitellum fractures (if significant swelling present) Elbow fracture/dislocations (after the appropriate reduction is achieved) Medicine (Baltimore). Long casts have been used in orthopaedics for many decades, and even as far back as 1938, Lambrinudi, published in the Guy's Hospital Gazzette, pointed out that the Colles fracture was caused by wrist trauma with the forearm in supination, and should therefore be immobilised by means of a long cast with pronation of the forearm [ 16 ]. 2. Casts immobilize the joint above and the joint below the area that is to be kept straight and without motion. 6. Once the materials are accurately and efficiently applied, the splint is molded to the desired shape to promote the continued reduction of the injured structures. Identify the technique of a long arm splint. Positioning is key to making a successful long arm cast. Optionally, stockinette can be used for patient comfort as a base layer before splinting. Of note, fiberglass provides a more consistent appearance on X-ray than plaster, making fractures potentially easier to visualize.[8][9]. Religious signature on an arm cast. Certain low-energy, non-displaced pilon fracture patterns may fare well with cast application as long as vigorous follow-up is scheduled to monitor for fracture displacement. Posterior long arm splinting is used in the management of multiple upper-extremity injuries. 2008 Jan. 102 (1):10-4. Fractures of the proximal humerus account for 1%-5% of all fractures [], with an incidence of 13-14 cases per 100,000 population and a bimodal distribution, with a peak in young adults aged 20-30 years related to high-energy trauma and another in the elderly due to falls from their own height and lower-energy trauma associated with osteoporosis [1, 2]. encoded search term (Posterior Long Arm Splinting) and Posterior Long Arm Splinting. Long Arm Cast. Make an edit and help improve WikSM for everyone. Credits. Return to Technical Skills Home. If fiberglass is used, the same techniques can be used, but web roll is not required for overwrapping as long as the fiberglass comes in a synthetic sheath. Contents. The thermoplastic material is positioned beginning at the dorsal metacarpal heads, along the dorsal aspect of the forearm, around the posterior elbow (capturing the medial and lateral epicondyles), and placed along the volar aspect of the forearm extending . Attach the strap with the Velcro fasteners. J Pediatr Orthop. Medscape Education. Apply casts and splints and prescribe orthoses. Long arm splints are often the initial form of immobilization placed on an injured limb to accommodate soft tissueswelling before more definitive treatment with a cast or surgical fixation. Splints thatare over aggressively molded can cause skin breakdown at the point of maximal pressure. Reichman's Emergency Medicine Procedures. Roberts JR, Custalow CB, Thomsen TW, Chanmugam AS, Chudnofsky CR, DeBlieux PMC, et al, eds. Images IV. 03. Principles Of Casting And Splinting. Long arm splints are a valuable tool in the treatment of a variety of upper extremity injuries. Most commonly, it is fabricated with the forearm in neutral. Vuolteenaho K, Moilanen T, Moilanen E. Non-steroidal anti-inflammatory drugs, cyclooxygenase-2 and the bone healing process. Police drama. Application of a basic long arm cast with Delta-Cast Conformable, Delta-Cast Elite, Delta-Cast Prints, Delta-Lite Conformable, Delta-Lite Plus.http://www.bsn. The Cochrane database of systematic reviews. Suzanne Bentley, MD, MPH, FACEP, CHSE Associate Professor, Departments of Emergency Medicine and Medical Education, Icahn School of Medicine at Mount Sinai; Chief Wellness Officer, Director of Simulation Innovation, Research and Scholarship, NYC Health + Hospitals, Elmhurst Hospital Center Musculoskeletal injuries typically require a period of immobilization to allow damaged structures to heal. lenovo v14 i3 review. Describe the steps of correct casting techniques for the most frequent indications. If the splint is too tight, it can lead to compartment syndrome, without devastating consequences. This form of splinting can provide excellent immobilization while allowing for swelling that often accompanies acute injuries. Skip toiletries. 06. Photos show a long-arm cast made of fiberglass with cotton lining. 2019 Feb. 39 (2):76-84. Thermal injury with contemporary cast-application techniques and methods to circumvent morbidity. Am Fam Physician. Naik AA, Xie C, Zuscik MJ, Kingsley P, Schwarz EM, Awad H, et al. All patients who are placed in a splint or cast require careful monitoring to ensure proper recovery. Examples of injuries for which a short arm cast might be appropriate include the following: distal forearm fractures, . Howard A, Mulpuri K, Abel MF, Braun S, Bueche M, Epps H, et al. Boyd A S Et Al. Preparation of a long arm cast involves several steps. A long arm cast is put on if the forearm or elbow is broken. Care is taken to create a natural space for the thumb. Ask the doctor what the cast will be made of. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), Emergency Medicine Residents' Association. [ 1, 2] Splints stabilize injuries by decreasing movement and providing support, thus. A long arm cast is maintained for 3-4 . Define the basic steps of post application treatment. Splint should extend from the medial aspect of the arm near the axilla around the elbow and up to the acromioclavicular joint. Patients should address specific medical concerns with their physicians. Share cases and questions with Physicians on Medscape consult. 19. Risks and benefits were discussed at length with the . It includes access to 55 cast and splint demonstrations on high-quality online video. Photos with arm casts and leg casts. Ortho-glass) as shown, along posterior/ulnar aspect of arm These casts are applied for fracture healing of the knee or a dislocation, and after surgery of the knee or leg. We need you! INDICATIONS: The patient is 5 years old. Photos. 1539] Description: Severe infection of the bone, bone marrow, and surrounding soft tissue Staphylococcus aureus is a common cause Etiology (Methods of Infection): Indirect entry (hematogenous): o Blunt trauma (usually in boys younger than 12 years old because they are very active) o Vascular insufficiency . Also of note, it is important to lay on web roll with 50% overlap to maintain even padding without irregularities, which can be a source of irritation. Other times, a ready-made splint will be used. Ittypicallyis removed, and patients are transitioned into more definitive immobilization such as a cast. New York: McGraw-Hill; 2020. Closed reductions cannot be maintained and should not be attempted. Elbow, or forearm fractures. and must extend from at least 1 inch proximal to the fracture site to wrist, w/ elbow at right angle & forearm in neutral rotation; - arm must lie dependent to provide a traction force; . [QxMD MEDLINE Link]. Long arm cast Cast Application Long arm cast Queen's University Technical Skills Program The long arm cast may be used for: Mid to proximal forearm fractures Elbow fractures and dislocations Distal humeral fractures The guidelines for casting around the hand are the same as in short arm casts. Treasure Island, FL: StatPearls; 2021. Cylindrical leg cast - for fractured patella. J Pediatr Orthop. After setting the bones align cotton wool and paper bandages are applied. Recognize potential for and prevent complications. Long arm splints are used for certain injuries requiring immobilization of the elbow. However, you still need to be careful anytime you cross the elbow with fiberglass. Pearls 1. These off-the-shelf splints are made in a variety of shapes and sizes and are much easier and faster to use. Long arm backslab Indications Peri-elbow fractures Smith's Dual Radius + Ulna fractures Steps: Position patient Prepare slab of 8 layers of 15cm wide POP at minimum Length - Middle of upper arm to just proximal to MCP joints Cut slits at elbow on either side to allow them to overlap The book can be purchased both as a hard copy and as a E-Book. As a result, elbow flexion and extension and wrist flexion, extension, forearm supination/pronation can be restricted. [Full Text]. [QxMD MEDLINE Link]. As a result, elbow flexion and extension and wrist flexion, extension, forearm supination/pronation can be restricted. Long Arm Cast. 2020 Feb. 40 (2):e122-e126. IMG_0027a screenshot to cast or not to cast first impression from the still ongoing weekend lac and ankleboots close up, ready to rendezvous Nice cast on a beautiful girl black and white To Roma with cast IMG_0035a my first fibercast LATS LAC and summerdress miss the summerfeeling Posterior long arm splinting. Synthetic or cotton web rollshould beobtained for padding. A contrast dye visible in X-rays is injected through the catheter. Indications for Use 1. The practitioner needs to take time to become familiarwith the materials and techniques needed to make a well-padded and molded splint that properly positions a patient to maintain a reduction and allow for soft tissue swelling. Long arm splints may be applied by many healthcare workers including therapists and orthopedic nurses. The cast would go from the knuckles to the upper arm. For fiberglass, most splinting materials come pre-fabricated. Long arm cast Applied from the upper arm to the hand. Long leg casts are also referred to as full leg casts. 3rd ed. To efficiently assemble a long arm cast, the practitioner should recruit the help of at least one other person. Ittypicallyis removed, and patients are transitioned into more definitive immobilization, such as a cast. 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