TRAUMA AND ORTHOPAEDICS London North West Healthcare NHS Trust

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

Local Complications
Systemic
Complications

Deep Vein
Thrombosis

Muscle cramps

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
TRAUMA AND ORTHOPAEDICS London North West Healthcare NHS Trust

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
TRAUMA AND ORTHOPAEDICS London North West Healthcare NHS Trust

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
TRAUMA AND ORTHOPAEDICS London North West Healthcare NHS Trust

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: 07876590704

Any medical questions: please call the hospital on - 02088643232 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 : 07876590704 (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 Special interest in lower limb surgery

(Hips and Knees) - Bleep 302

MR S JENNINGS Special interest in lower limb surgery

(Hips and Knees) – Bleep 302

4
TRAUMA AND ORTHOPAEDICS London North West Healthcare NHS Trust

MR J PEREZ Special interest in upper limb surgery

Bleep 312

MR M SALA Special interest in upper limb surgery

Bleep 308

Mr A R GUPTA Special interest in lower limb surgery

(Hips and Knees) – Bleep 315

MR AL-YASSARI Special interest in upper limb surgery

Bleep 312

MR I HOLLOWAY Special interest in lower limb surgery

(Hips and Knees) – Bleep 302

MR J MURPHY Special interest in upper and lower limb

surgery – Bleep 315

MR L FREEDMAN Special interest in Knee surgery – Bleep 315

MR G ALLARDICE Special interest in Foot and Ankle surgery

Bleep 306

MR GIYAS BHATTEE Special interest in lower limb surgery

(Hips and Knees) – Bleep 311

MR K LEHDORFF Special interest in lower limb surgery

Bleep 308

DR S BATTACHARYYA Ortho- Geriatrician – Bleep 172

Central Middlesex Hospital

Mr A R GUPTA Special interest in lower limb surgery

(Hips and Knees) – Bleep 315

MR J HOLLINGDALE Special interest in Knees surgery

Bleep 997

5
TRAUMA AND ORTHOPAEDICS London North West Healthcare NHS Trust

MR MICK PEARSE Special interest in lower limb surgery

Bleep 997

MR K LEHDORFF Special interest in lower limb surgery

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