Types, definition of different CAST AND SPLINT-
- 3. Casts and splints are orthopedic devices that are used to protect and support broken or injured bones and joints. They help to immobilize the injured limb to keep the bone in place until it fully heals. Casts differ from splints because they provide more support and protection for a limb that is injured or broken. They are made from materials like plaster or fiberglass that can be easily molded to the shape of the injured arm or leg.
- 4. Splints, also known as half-casts, provide less support than casts, but are faster and easier to use. They also can be tightened or loosened easily if the swelling in the arm or leg increases or decreases
- 6. INDICATION FOR CAST Fractures. Severe sprains. Dislocations. Protection of post-operative repairs. Gradual correction of a deformity with serial casting.
- 7. Casts are a common treatment for fractures. Casts are used to immobilize injured bones, promote healing, and reduce pain and swelling while the bone heals. They are sometimes put on an arm or leg after surgery to protect the bone and ensure it remains in proper alignment.
- 8. Provide pain relief of the fractured limb. Support bone ends of the fracture site. Bones ends of the fracture site are very sharp. A splint helps prevent bone protruding through the skin, soft skin and tissue damage, as well as bleeding. Facilitate safe and seamless causality transport INDICATION FOR SPLINTS
- 9. CONTRAINDICATIONS OF CAST Acute infection. Tracking wound, ulcer depth greater than width. Excessively draining wound. Claustrophobia. Fragile skin. Excessive swelling.
- 10. CONTRAINDICATION FOR SPLINTS Injuries that violate the skin or open wounds. Injuries that result in sensory or neurologic deficits. Injuries to the vasculature require special attention by vascular surgeons, as these may require urgent operative intervention. Patients with peripheral vascular disease or neuropathy.
- 11. A basic rule of splinting is that the joint above and below the broken bone should be immobilized to protect the fracture site. For example, if the lower leg is broken, the splint should immobilize both the ankle and the knee. Pulses and sensation should be checked below the splint at least once per hour.
- 12. Short-arm cast ■Below elbow to proximal palmar crease ■Gauntlet cast Below elbow to proximal palmar crease including thumb Long-arm cast Axillary fold to proximal palmar crease Short-leg cast ■Below knee to base of toes ■Long-leg cast ■ Upperthigh to base of toes TYPES OF CAST
- 13. ■Body cast Encircles the trunk stabilizing the spine ■ Spica cast ■Incorporates the trunk and the extremity ■Cast-brace Constructed with hinges to permit early motion of joints ■Cylinder cast ■ Used for fracture or dislocation of knee or elbow Body jacket cast Single hip spica Double hip spica
- 19. PROCEDURE FOR CAST APPLICATION wraps a liner of soft material(Soft ban) around the injured area (for a waterproof cast, a different liner is used). wets the cast material with water. wraps the cast material around the first layer. waits until the outer layer dries to a hard, protective covering.
- 22. What you’ll need for splinting an injury The first thing you’ll need when making a splint is something rigid to stabilize the fracture. Items you can use include: a rolled-up newspaper a heavy stick a board or plank a rolled-up towel
- 23. HOW TO APPLY A SPLINT Attend to any bleeding. Apply padding. Place the splint. Watch for signs of decreased blood circulation or shock.
- 24. Measuring the stockinette. Black lines indicate the ends of the intended splint. Ulnar gutter splint is used to illustrate the procedure
- 25. Stockinette application. Stockinette should extend about 10 cm beyond each end of the intended splint site. Black lines beneath the stockinette indicate the ends of the intended splint.
- 27. To create a splint without stockinette, padding that is slightly wider and longer than the splinting material should be applied in several layers directly to the smoothed, wet splint. Together, the padding and splinting material are molded to the extremity.
- 29. layers of padding are placed over the stockinette to prevent maceration of the underlying skin and to accommodate for swelling. Padding is wrapped circumferentially around the extremity, rolling the material from one end of the extremity to the other, each new layer overlapping the previous layer by 50 percent.
- 30. Dry, layered splint material should be submerged in water until bubbling from the materials stops. The splint is removed and excess water squeezed out. To estimate the length of splint material needed, dry splint should be laid next to the area being splinted .An additional 1 to 2 cm should be added at each end of the splint to allow for shrinkage that occurs during wetting, molding, and drying. Ultimately, the splint should be slightly shorter than the padding.
- 32. For an average-size adult, upper extremities should be splinted with six to 10 sheets of material, whereas lower extremity injuries may require 12 to 15 sheets. Use of more sheets provides more strength, but the splint will weigh more, produce more heat, and be bulkier. In general, the minimum number of layers necessary to achieve adequate strength should be used.
- 33. Finally, the stockinette and padding edges are folded back to create a smooth edge .The dried splint is secured with an elastic bandage wrapped in a distal to proximal direction
- 37. Ulnar gutter splint Ulnar gutter cast
- 38. COMPLICATIONS OF CAST AND SPLINTS Compartment syndrome. Thermal injuries. Pressure sores. Skin infection and dermatitis. joint stiffness are possible complications of splinting and casting. Patient education regarding swelling, signs of vascular compromise, and recommendations for follow-up is crucial after cast or splint application.
- 39. Educating patients about cast and splint care is crucial. They should receive both verbal and written instructions on the importance of elevating the injured extremity to decrease pain and swelling, and on splint/cast care and precautions. They should also refrain from getting the material wet or pushing objects inside a cast to scratch. It is extremely important that patients continually check for signs of compartment syndrome and report immediately to an urgent or emergent care facility for removal of the cast or splint at the first sign of vascular compromise.
- 40. FOLLOW UP AND IMMOBILIZATION Time to follow-up and length of immobilization are extremely variable, depending on the site, type, and stability of the injury and on patient characteristics (e.g., age, accessibility, compliance). Most splints and casts require initial follow-up within one to two weeks after application, and most fracture guidelines estimate four to eight weeks for healing. However, all injuries must be assessed, treated, and followed on an individual basis.
- 41. Reider B, ed. The Orthopaedic Physical Examination. Philadelphia, Pa.: Saunders; 1999:2–17. Chudnofsky CR, Byers S. Splinting techniques. In: Roberts JR, Hedges JR, Chanmugam AS, eds. Clinical Procedures in Emergency Medicine. 4th ed. Philadelphia, Pa.: Saunders; 2004:989. Simon RR, Koenigsknecht SJ, eds. Emergency Orthopedics: The Extremities. Norwalk, Conn.: Appleton and Lange; 1995:3–20. Eiff MP, Hatch R, Calmbach WL, eds. Fracture Management for Primary Care. 2nd ed. Philadelphia, Pa.: Saunders; 2003:1–39. Wehbé MA. Plaster uses and misuses. Clin Orthop Relat Res. 1982(167):242-249. REFERENCES
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