Which cast is used for fracture of the shaft of the humerus?

• A. Shoulder Spica Cast
• B. Short Arm Circular Cast
• C. Munster/Fuenster Cast
• D. Hanging Cast

Answer: (D)

Fractures of the humeral shaft are treated with immobilization that pulls gently along the arm to align the fragments and prevent rotation while keeping the shoulder and elbow in a stable position. The hanging cast achieves this by applying a steady traction through a pulley system attached to the forearm, within a long arm cast, so the humerus is held in proper alignment as it heals.

A shoulder spica cast, while useful for shoulder or proximal humerus injuries, would immobilize the shoulder region more than necessary and isn’t ideal for mid-shaft fractures. A short arm circular cast ends at the forearm and cannot control alignment of the fracture in the upper arm, since there’s no traction or stabilization of the proximal fragment. The Munster/Fuenster long-arm casts immobilize the arm but do not provide the continuous longitudinal traction that helps maintain reduction in a shaft fracture, making them less effective for this specific pattern. Therefore, the hanging cast is the best choice for a fracture of the humeral shaft.