Fracture Treatment Guidelines

Fractures: Cast-on

Draping and Pillowing

  • Secure, stable and neutral position
  • Be sure there is no stress on fractured area


  • Check nail beds for blood flow
  • Place cold hydrotherapy on fingers
  • Be sure to check in visually, vocally and through touch

Specific Treatment

  • Perform lymph drainage
  • Perform fluid techniques
  • Tell client to perform diaphragmatic breathing
  • Perform vibration through cast
  • Effleurage proximal to cast
  • Be sure to not have are in traction!

Fractures: Cast-Off


  • mild hydro (not too cold, not too hot) to decrease autonomic response

Specific Treatment

  • Lymph drainage if fluid present
  • Decrease trigger points in proximal limb
  • Perform light, stimulating techniques of the area that was casted


  • Check in with client with heat and trigger points
  • Make sure the area is stable throughout

Lymph Drainage Review

  • Begin with 30 pumps at termini
  • Next, 30 pumps at axilla or popliteal fossa
  • Pump down towards cast, 5 -7 pumps at an area
  • Clear axillary or popliteal fossa with 30 pumps
  • Clear termini with 30 pumps

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