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Effects of Upper Extremity Elevation on Intra-Cast Pressure and Digital Perfusion in a Fiberglass Short-Arm Cast Model
Journal article   Peer reviewed

Effects of Upper Extremity Elevation on Intra-Cast Pressure and Digital Perfusion in a Fiberglass Short-Arm Cast Model

Brianna R. Fram, Dennis P. Martin, William L. Wang, Kelly Byrne, Brandon L. Rogalski, Andrew G. Park and Asif M. Ilyas
Orthopedics (Thorofare, N.J.), v 44(4), pp E487-E492
01 Jul 2021
DOI: https://doi.org/10.3928/01477447-20210618-05
PMID: 34292830
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Life Sciences & Biomedicine Orthopedics Science & Technology
The goal of this study was to determine the relationship of digital artery pressure to arm position and forearm skin surface pressure using a short-arm cast experimental setup, to ascertain the safest position for the injured casted upper extremity. A total of 27 volunteers were placed in bilateral short-arm fiberglass casts with an empty 50-mL bladder bag under the cast and attached to a pressure transducer. Digital systolic pressure (P-dig), and skin surface pressure under the cast (P-skin) were assessed in 4 positions. Measurements were taken with and without 50 mL air in the bladder bag. A total of 54 forearms were evaluated. Both arm position and P-skin had a significant effect on P-dig (P<.001 for both), with increasing elevation leading to a decrease in P-dig (r=-0.50). The effect size of position on P-dig was large, whereas that of P-skin was small (partial eta-squared=0.371 and 0.028, respectively). Linear regression analysis of P skin and P dig with air in the neutral position yielded a moderate negative relationship with body mass index (r=-0.64, P<.001 for P-skin; r=0.49, P<.001 for P-dig) and wrist circumference (r=-0.66, P<.001 for P-skin; r=0.52, P<.001 for P-dig), without significant association with forearm length. For volunteers with short-arm fiberglass casts, increasing arm elevation had a large effect size on digital arterial pressure, whereas 50 mL simulated swelling had only a small effect size. Decreasing body mass index and forearm circumference correlated with increased skin surface pressure and decreased digital arterial pressure. These findings show that aggressive elevation of the injured limb may not be as desirable as previously believed.

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Collaboration types
Domestic collaboration
Web of Science research areas
Orthopedics
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