Which cast is associated with fracture of the upper portion of the humerus and shoulder joint with open wound swelling and infection?

• A. Shoulder Spica Cast
• B. Sugar Tong
• C. Short Arm Posterior Mold
• D. Abduction Splint/Airplane Cast

Answer: (B)

When swelling or infection is present, the goal is to immobilize the limb without strangling the soft tissues or trapping pus and edema. A splint that is noncircumferential and can be easily adjusted as swelling changes is preferred.

The sugar-tong splint fits this need because it provides solid immobilization of the forearm and elbow while not wrapping tightly around the entire arm or shoulder. Its design allows easy access for wound care and monitoring of infection, and it can be loosened or adjusted as swelling arises or subsides. This makes it a safer initial option for injuries around the upper arm and shoulder when there is an open wound and edema.

In contrast, a shoulder spica casts encircle the trunk and shoulder and can constrict as swelling evolves, making wound care harder and increasing skin risk. A short arm posterior mold binds the forearm and elbow but offers less protection for the shoulder area. An abduction or airplane cast fixes the shoulder in an abducted position but is a circumferential cast around the chest/upper arm and can be less adaptable to swelling and infection management.