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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Broken Malleoli, Cast Replaced, New One Tight. Capillary Test Shows Blood Flow Less. Solution?

Broken Malleoli, I had my cast on my left ankle replaced yesterday due to it being too loose, literally could fit my hand into the cast half way down my shin and when I got up the cast would fall and rest on my foot and on the injured ankle. I am finding the new cast tight but am not sure how tight they should fit, is snug fit normal? I can wiggle my toes and do keep my leg consistently raised. I got a family member to do a capillary test on my toes and found that the return of blood flow is very slight, mainly white and patchy. I am very uncomfortable....
Tue, 6 Aug 2013
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Orthopaedic Surgeon, Joint Replacement 's  Response
Hi, thanks for writing to HCM.

If the capillary filling in the nail beds is sluggish, then the cast needs to be immediately cut opened to loosen it so as to improve the circulation in the toes. This is an emergency as any amount of delay can be detrimental to the viability of the involved structures.

I suggest you to consult your treating doctor for further workup and management.

Hope this information is helpful . Good day

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Broken Malleoli, Cast Replaced, New One Tight. Capillary Test Shows Blood Flow Less. Solution?

Hi, thanks for writing to HCM. If the capillary filling in the nail beds is sluggish, then the cast needs to be immediately cut opened to loosen it so as to improve the circulation in the toes. This is an emergency as any amount of delay can be detrimental to the viability of the involved structures. I suggest you to consult your treating doctor for further workup and management. Hope this information is helpful . Good day