Lesson 1Indications and Contraindications for Below-Elbow Casts and Removable Wrist BracesExplains when below-elbow casts or removable wrist braces suit distal radius fractures, detailing stability criteria, patient factors, and cases needing alternative immobilisation or surgical advice.
Stable versus unstable fracture featuresAge and activity level considerationsContraindications to circumferential castingWhen to prefer removable wrist bracingRed flags requiring orthopedic referralShared decision-making with patientsLesson 2Anatomy of Distal Radius, Paediatric/Adolescent Bone Physiology, and Fracture Healing TimelinesExamines distal radius anatomy, growth plate aspects, and paediatric bone physiology, connecting these to common fracture types, remodelling capacity, and practical healing timelines that inform immobilisation and follow-up decisions.
Osteology of distal radius and ulnaPhyseal anatomy and growth contributionPediatric cortical and cancellous bone traitsCommon distal radius fracture patternsRemodeling potential by age and planeExpected healing timelines by ageLesson 3Materials and Equipment List: Stockinette, Cotton/Padded Rolls, Plaster vs Fibreglass Properties, Water Temperature, Casting Scissors and SawsOutlines key casting materials and tools, contrasting plaster and fibreglass traits, padding sizing and layers, safe water temperatures, and proper handling of scissors, spreaders, and oscillating saws in practice.
Stockinette sizing and applicationPadding selection and layering techniquePlaster versus fiberglass characteristicsWater temperature and setting controlSafe handling of scissors and spreadersOscillating cast saw safety principlesLesson 4Positioning and Moulding Technique: Wrist Position, Forearm Rotation, Elbow Position, and Acceptable AngulationDetails ideal wrist, forearm, and elbow positioning for distal radius fracture casting, including tolerable residual angulation, and moulding techniques that hold reduction while ensuring function and comfort.
Functional wrist flexion and extension anglesForearm rotation for different patternsElbow position and patient comfortAcceptable angulation by age and planeThree-point molding over fracture siteAvoiding rotational malalignmentLesson 5Immediate Post-Application Checks: Capillary Refill, Finger Mobility, Pressure Point Assessment, Comfort and FitDescribes routine checks right after immobilisation, covering perfusion, motor and sensory functions, pressure spots, and cast fit to spot early issues and guarantee safe, comfortable support before discharge.
Capillary refill and skin color assessmentActive and passive finger motion testingSensory screening of median and ulnar nervesPalpation of bony and soft tissue pressure pointsAssessment of cast edges and overall fitDocumentation and communication of findingsLesson 6Patient Education: Cast Care, Moisture and Hygiene Precautions, Activity and Lifting Guidance for Dominant Hand InjuriesOffers clear instructions for patients and caregivers on cast maintenance, moisture and hygiene tips, itch relief, safe activities, lifting restrictions for dominant hand cases, and signs needing quick review.
Daily cast inspection and skin careMoisture, bathing, and swimming precautionsManaging itch and avoiding foreign objectsActivity restrictions and lifting limitsReturn to school, work, and sports timingWhen and how to seek urgent reviewLesson 7Types of Below-Elbow Immobilisation: Short Arm Plaster Cast, Short Arm Fibreglass Cast, Volar Wrist Splint, Removable Wrist Brace — Design and Biomechanical EffectsDiscusses below-elbow options for distal radius fractures, covering build, uses, and effects of short arm plaster and fibreglass casts, volar splints, and removable braces on movement control and ease.
Short arm plaster cast designShort arm fiberglass cast designVolar wrist splint indicationsRemovable wrist brace indicationsControl of flexion, extension, and rotationImpact on function and daily activitiesLesson 8Step-by-Step Application of Short Arm Plaster and Fibreglass Casts with Key Technical Tips for Padding and Three-Point MouldingGives a step-by-step process for applying short arm plaster and fibreglass casts, stressing padding methods, overlap, wrinkle prevention, three-point moulding, and tips to avoid sores and keep reduction stable.
Preparation of materials and patient positioningStockinette and padding application detailsPlaster bandage application sequenceFiberglass bandage application sequenceThree-point molding over fracture apexFinal inspection and edge trimmingLesson 9Warning Signs and Urgent Review Criteria: Increasing Pain, Numbness, Swelling, Tight Cast, Smell or DischargeIdentifies post-immobilisation warning signs needing urgent attention, like rising pain, numbness, swelling, bad smell, discharge, or cast issues, with triage guidance and documentation duties.
Disproportionate or increasing painNew numbness, tingling, or weaknessProgressive swelling or tight cast feelingSmell, discharge, or cast softeningCast cracks, dents, or loose fitTriage instructions and documentationLesson 10Follow-Up Schedule and Radiographic Check Timing, Cast Removal Considerations, Graduated Mobilisation and Referral to PhysiotherapyReviews follow-up timings, radiograph schedules to check reduction, cast change or removal criteria, and plans for gradual mobilisation, strengthening, and referrals to physiotherapy or hand therapy.
Initial post-casting review timingRadiographic schedule and viewsMonitoring for loss of reductionCriteria for cast change or wedgingSafe timing of cast removalStaged mobilization and therapy referralLesson 11Pre-Application Clinical Checks: Skin, Swelling Assessment, Neurovascular Exam, Compartment Syndrome SignsCovers vital pre-application evaluations, including skin checks, swelling review, neurovascular tests, and spotting compartment syndrome signs that could change immobilisation plans.
Inspection for wounds and skin compromiseAssessment of swelling and soft tissue statusBaseline motor and sensory documentationPeripheral pulses and capillary refillEarly signs of compartment syndromeDeciding to delay or modify casting
