This 2008 narrative review by Halanski and Noonan examines the full spectrum of complications from cast and splint immobilization — from thermal burns and pressure sores to compartment syndrome and DVT — and identifies which patients and techniques carry the greatest risk.
When you apply or supervise a cast — especially in a child, an obtunded patient, or anyone with impaired sensation — treat every pain complaint as a potential compartment syndrome until proven otherwise, keep dip water below 50°C and plaster under 24-ply, use the stretch-relaxation technique for fiberglass, and counsel all adults in lower extremity casts about a DVT risk that LMWH may not meaningfully reduce.
This 2008 narrative review by Halanski and Noonan examines the full spectrum of complications from cast and splint immobilization — from thermal burns and pressure sores to compartment syndrome and DVT — and identifies which patients and techniques carry the greatest risk.
When you apply or supervise a cast — especially in a child, an obtunded patient, or anyone with impaired sensation — treat every pain complaint as a potential compartment syndrome until proven otherwise, keep dip water below 50°C and plaster under 24-ply, use the stretch-relaxation technique for fiberglass, and counsel all adults in lower extremity casts about a DVT risk that LMWH may not meaningfully reduce.