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Cast Care (cont.)

Complications

Many potential complications are related not only to wearing a cast but also to the healing of the underlying fracture.

Immediate complications

Compartment syndrome

  • Compartment syndrome is a very serious complication that can happen because of a tight cast or a rigid cast that restricts severe swelling.
  • Compartment syndrome happens when pressure builds within a closed space that cannot be released. This elevated pressure can cause damage to the structures inside that closed space or compartment - in this case, the muscles, nerves, blood vessels, and other tissues under the cast.
  • This syndrome can cause permanent and irreversible damage if it is not discovered and corrected in time.
  • Signs of compartment syndrome
    • Severe pain
    • Numbness or tingling
    • Cold, pale, or blue-colored skin
    • Difficulty moving the joint or fingers and toes below the affected area.
  • If any of these symptoms occur, call the doctor or go to the emergency department immediately. The cast may need to be loosened or replaced.

A pressure sore or cast sore can develop on the skin under the cast from excessive pressure by a cast that is too tight or poorly fitted.

Delayed complications

  • Healing problems
    • Malunion: The fracture may heal incorrectly and leave a deformity in the bone at the site of the break. (Union is the term used to describe the healing of a fracture.)
    • Nonunion: The edges of the broken bone may not come together and heal properly.
    • Delayed union: The fracture may take longer to heal than is usual or expected for a particular type of fracture.
  • Children are at risk for a growth disturbance if their fracture goes through a growth plate. The bone may not grow evenly, causing a deformity, or it may not grow any further, causing one limb to be shorter than the other.
  • Arthritis may eventually result from fractures that involve a joint. This happens because joint surfaces are covered by cartilage, which does not heal as easily or as well as bone. Cartilage may also be permanently damaged at the time of the original injury.

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