The Role of the Orthopaedic Practitioner/Casting Room Nurse

The qualified Orthopaedic Practitioner/Casting Room Nurse is a vital member of the healthcare team providing a service not just in Orthopaedics and Trauma but also Trust-wide across many different specialties. In a similar way to Orthotists and Physiotherapists, they interpret prescriptions from a wider multidisciplinary team, being able to discuss issues of care with other relevant Healthcare Professionals.

Orthopaedic Practitioners/Casting Room Nurses assess, plan, implement and evaluate care episodes using, wherever possible, evidence-based practice. They have a wide knowledge of commercially available products and will choose appropriately, both for efficacy and cost effectiveness using evidence and auditing their practice on the description of their role in the above, it can be seen that Orthopaedic Practitioners/Casting Room Nurses have to practise autonomously and have a very definite potential for harm to the patient if they do not exercise good clinical judgement. Some of the complications that can arise are:

  • Circulatory impairment, including Compartment Syndrome.
  • Nerve impairment caused by poorly applied cast or as part of the circulatory impairment.
  • Long-term problems for the patient from either incorrect position of the fractured limb, incorrect position of the cast or an incorrect cast being applied.
  • Pressure sores inside the cast due to incorrect/poor casting techniques or patient intervention (i.e. foreign objects inside the cast) resulting from lack of proper instruction to the patient.
  • Stiffness of joints due to incorrect extent of the cast obstructing movement of the adjacent joint(s) or lack of instruction to the patient regarding specific appropriate exercises, although, obviously, joints held within a cast may get stiff.
  • Allergic reaction to cast materials if the Orthopaedic Technician fails to assess the patient fully prior to treatment or fails to recognise the symptoms when an allergic reaction occurs.
  • Many cases of litigation relate to cast removal and to poor use of the electric cast saw. These result in burns and cuts, which can cause serious scarring.


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