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Hand & Finger Casts: Ulnar Gutter, Radial Gutter & Thumb Spica

Instructor: Dan Washmuth

Dan has taught college Nutrition, Anatomy, Physiology, and Sports Nutrition courses and has a master's degree in Dietetics & Nutrition.

Do you know which specific type of injuries require the use of ulnar gutter, radial gutter, and thumb spica casts? This lesson will provide the answers to this question, as well as other great bits of information about these casts.

Almost a Touchdown!

Jace is a wide-receiver for a college football team. During a recent game, the quarterback threw Jace a deep pass that looked like a definite touchdown. As the ball came towards Jace, he misjudged the pass, and the ball slammed directly into the end of his right thumb. Immediately, an intense pain shot through Jace's thumb. He was pretty sure he severely injured his thumb, but he stayed in the game.

After the game, Jace looked at his finger and noticed it had swollen to about three times its normal size. He showed the team doctor who then took an x-ray of the thumb that revealed that Jace had broken his thumb. The doctor then put a temporary splint on his thumb and told Jace to come back once the swelling had gone down. Three days later, Jace returned and the doctor the put a thumb spica cast on his thumb.

Injuries to the hand and fingers can occur to anyone, not just athletes like Jace. You can fracture a bone in your hand or finger by simply tripping and falling onto your outstretched arms and hands. (The bones in the hand are called metacarpals, and the bones in the fingers are called phalanges). Ulnar gutter, radial gutter, and thumb spica casts are specific types of casts used to provide long-term immobilization for these types of injuries so they may heal properly and effectively.

Ulnar gutter, radial gutter, and thumb spica casts are most commonly used for fractured metacarpals and phalanges.
hand bones

Ulnar Gutter and Radial Gutter Casts

Ulnar gutter casts are used for fractures to the metacarpals and phalanges of the pinky and ring fingers, while radial gutter casts are used for fractures to the metacarpals and phalanges of the middle and pointer fingers. Ulnar and radial gutter casts are also used for torn ligaments of these fingers as well.

These casts are usually made out of plaster or fiberglass, and enclose the injured finger(s), hand, wrist, and most of the forearm. When ulnar gutter and radial gutter casts are applied, the wrist is usually in a slightly extended position (bent backwards), and the injured fingers are flexed forward and rounded.

Thumb Spica Casts

As you can probably guess by the name, thumb spica casts are used for bone fractures and ligament tears of the thumb. This type of cast is also used for fractures to the scaphoid, which is a small, round bone in the thumb side of the wrist. Thumb spica casts enclose the thumb, hand, wrist, and most of the forearm while leaving the fingers free to move around. The hand is usually in a slightly extended position, and the thumb is usually in a position as if the hand was holding a can of soda.

This is an example of a thumb spica cast, used for a fractured thumb.
thumb spica

It should be noted that each of these casts is usually applied anywhere from 1-7 days after the initial injury to allow the swelling to go down. While the swelling goes down, a person will usually wear a removable splint that allows room for additional swelling. Once the swelling goes down, the splint is replaced with a cast (just like Jace).

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