CAS1S

O ls a Lemporary lmmoblllzaLlon
1ypes
O |aster
O I|ber g|ass
Iunct|on
O 1o promoLe heallng and early welghL bearlng
O 1o supporL malnLaln and proLecL reallgned bone
O 1o prevenL or correcL deformlLy
O 1o lmmoblllze
Cast App||cat|on
1 pply Lhe sLocklneLLe
2 pply Lhe waddlng sheeL
3 llber glass or Lhe plasLer casL
Contra|nd|cat|ons
1 9regnancy
2 Skln dlsease
3 Swelllng
4 Cpen wound
3 lnfecLlon
-urs|ng Intervent|ons
1 andle weL casL wlLh palms of hands noL flngers
2 CasL should be allowed Lo alr dry
3 LlevaLe Lhe casL on one or Lwo plllows durlng drylng
4 Cbserve hoL spoL" and musLy odor whlch ls slgns and sympLoms of lnfecLlon
3 MalnLaln skln lnLegrlLy peLalllng"
6 uo neurovascular checks such as skln color skln LemperaLure sensaLlon moblllLy and pulse
7 ssess for vascular occluslon
8 dheslve Lape peLals reduce lrrlLaLlon aL casL edges
9 9revenL compllcaLlon of moblllLy

*C|rcu|ar cast ls changed Lo poster|or mo|d lf Lhere are open wounds




























Cu? CS1 for lower dorsolumbar splne affecLaLlon

MlnL8v CS1 / !CkL1 ls used Lo lmmoblllze Lhe head
and parL of Lhe Lrunk ln Lhe LreaLmenL of LorLlcollls
cervlcal and Lhoraclc ln[urles and cervlcal splnal lnfecLlons


CCLL8 CS1 affecLlon of Lhe cervlcal splne


8lZZL8S !CkL1 scollosls


LCnC 8M Cl8CuL8 CS1 affecLlon of Lhe radlus and
ulna
SC81 8M Cl8CuL8 CS1 affecLlon of Lhe wrlsL and
flngers carpals and meLacarpals
LCnC 8M 9CS1L8lC8 MCLu affecLlons on radlus ulna
wlLh lnfecLlon open wound and swelllng
SC81 8M 9CS1L8lC8 MCLu affecLlons of Lhe wrlsL and
flngers wlLh lnfecLlons and open wounds carpals and
meLacarpals


nClnC CS1 affecLlon of Lhe shafL of Lhe humerus


lunC1lCnL CS1 affecLaLlon of Lhe shafL wlLh callus
formaLlon llow flexlon and exLenslon of Lhe upper
exLremlLy


MunS1L8 CS1 affecLlon of Lhe radlus ulna wlLh callus
formaLlon allows exLenslon and flexlon of Lhe elbow














l8CC CS1 CongenlLal hlp dlslocaLlon

9n1LCn CS1 affecLlon of Lhe pelvls

LCnC LLC Cl8CuL8 CS1 fracLure Llbla flbula
SC81 LLC Cl8CuL8 CS1 affecLlon of Lhe ankle and
legs Larsals and meLaLarsals
LCnC LLC 9CS1L8lC8 MCLu affecLlons of Lhe Llbla flbula
wlLh lnfecLlon open wounds
SC81 LLC 9CS1L8lC8 MCLu ankle and Loes wlLh
lnfecLlons and open wounds Larsals and meLaLarsals

C?LlnuL8 CS1 funcLlon of paLellar affecLaLlon (C?LlnuL8
9CS1L8lC8 MCLu lf open wound or swelllng)

SkL1 CS1 for commlnuLed paLellar Lo lmmoblllze fooL
knee and ankle whlle allowlng wound for exposure

uLLvl1 CS1 affecLlon of Lhe proxlmal Llbla flbula and
allow flexlon and exLenslon of Lhe knee

8CL CS1 affecLlon of Lhe dlsLal Lhlrd of femur and
proxlmal Lhlrd of Llbla flbula allows gradual flexlon of Lhe
knee

91LLL8 1LnuCn L8lnC CS1 ShafL Llbla flbula wlLh
callus formaLlon (w/ walker)

Cuu8lL1L8L CS1/ lSClL WLlC1 L8lnC CS1
funcLlon of Lhe shafL of femur wlLh callus formaLlon (w/
walker)




SICA CAS1S (also called a hlp splca casL or body casL) casL whlch lncludes Lhe Lrunk of Lhe body and one or more llmb
9urpose ls Lo lmmoblllze Lhe hlp(s) or broken bone and malnLaln Lhe correcLed poslLlon lL ls usually puL on ln surgery whlle
Lhe chlld ls sleeplng

SCuLuL8 S9lC CS1 affecLlon of Lhe upper porLlon of
Lhe humerus and shoulder [olnL
SCuLuL8 S9lC 9CS1L8lC8 MCLu affecLlon of Lhe
upper porLlon of Lhe humerus and shoulder [olnL wlLh
lnfecLlon open wound and swelllng


SlnCLL l9 S9lC CS1ffecLlon of Lhe hlp and femur
SlnCLL l9 S9lC 9CS1L8lC8 MCLu lmmoblllze ln[urles
and reconsLrucLlve surgerles of Lhe pelvls hlp [olnL and
areas of Lhe knee lnfecLlon open wound and swelllng



1Z l9 S9lC CS1 ffecLlon of Lhe hlp and femur


uCuLL l9 S9lC CS1 bllaLeral affecLlon of Lhe hlp and
femur


nlC1 S9Lln1 funcLlon for posL pollomyellLls paLlenL and
calf palns















1kAC1IC-
lL ls used Lo manage fracLures ln an efforL Lo reallgn broken bones lL ls ofLen used a s a Lemporary measure when operaLlve
flxaLlon ls noL avallable for a perlod of Llme
1ypes
O Ske|eta| 1ract|on dlrecL Lo Lhe bone made up of wlres Longs and plns
Lx Cver head LracLlon Skull LracLlon halo LracLlon hoen's
O Sk|n tract|on aLLaches Lo Lhe lnLacL skln Lo reallgn broken bones lnslde Lhe body
Lx uck's exLenslon LracLlon dunlop's LracLlon
4 Adhes|ve Sk|n 1ract|on wlLh adheslve Lapes
Medlal Lo laLeral (leave allowance before movlng Lo laLeral) bandage wood spreader aL Lhe lefL allowance
for LracLlon placemenL
4 -onadhes|ve sk|n tract|on aLLached wlLh canvass belL Lraps
Lx CoLrel
O Dnc|ass|f|ed tract|on applled wlLh a meLal spreader

SkuLL 1CnCS 18C1lCn are used Lo lmmoblllze Lhe cervlcal splne ln Lhe LreaLmenL of unsLable fracLures or dlslocaLlon of Lhe
cervlcal splne lLhough Crutchf|e|d tongs were used almosL excluslvely ln Lhe pasL GardnerWe||s sku|| tongs are ln wlde use
Some Lhlnk Lhese are less llkely Lo pull ouL Lhan Lhe CruLchfleld Longs 1he paLlenL ls prepared for elLher Lype wlLh a local
anesLheLlc Lo Lhe scalp 1he Longs are surglcally lnserLed lnLo Lhe bony cranlum and a connecLor halfhalo bar ls aLLached Lo a
hook from whlch LracLlon can be applled

1he paLlenL ls suplne and ls usually on a speclal frame lnsLead of Lhe regular hosplLal bed lf a hosplLal bed ls used Lwo or more
people are requlred Lo asslsL Lhe paLlenL wlLh any Lurnlng movemenLs 1he head of Lhe bed may be elevaLed Lo provlde counLer
LracLlon

ecause paLlenLs remaln ln Lhls Lype of LracLlon for an exLended perlod observe Lhe precauLlons Laken for Lhe paLlenL ln oLher
Lypes of skeleLal LracLlon ulfflculLles wlLh Lhe performance of acLlvlLles of dally llvlng lnfecLlon aL Lhe Long slLes and
resLlessness and boredom are common lL ls useful Lo Leach Lhe paLlenL rangeofmoLlon exerclses provlde good nuLrlLlon and
suggesL recreaLlonal or occupaLlonal acLlvlLles

CLn'S SkuLL 18C1lCn Wlres are passed Lhrough burr holes 1racLlon ls easler Lo allgn by Lhls meLhod Lhan wlLh a halo and
cannoL sllp off a paLlenL can move hls head freely and you can leave hlm ln LracLlon for monLhs lf necessary






Lu L1L8 18C1lCn cervlcal splne affecLlon WlLh head elevaLor or shock block Lo malnLaln reverse Lrendelenberg
poslLlon


LC 18C1lCn

llL Lhls ln Lhe ward SupporL Lhe paLlenL's head off Lhe bed Lry Lhe halo for flL and declde whlch screw holes Lo use Shavlng
Lhe skln ln Lhe areas where Lhe plns wlll go ls opLlonal naesLheLlze hls skln and apply Lhe halo ln Lhe same way as for Cardner
Wells Longs 1lghLen Lhe screws alLernaLely so LhaL Lhe halo ls noL pulled Lo one slde 1lghLen Lhem as securely as you can
uslng only your Lhumb and Lhree flngers on Lhe screwdrlver more force ls dangerous fLer LlghLenlng secure each pln wlLh
lock nuLs on elLher slde of Lhe halo
1hread cords Lhrough four of lLs unused holes brlng Lhe cords LogeLher lnLo Lwo sllngs and Lle Lhe maln LracLlon cord Lo Lhem
d[usL Lhem Lo deLermlne Lhe flexlon and exLenslon of hls head
(1)Make sure Lhe polnLs of Lhe screws are needle sharp (2) 1ry Lo keep Lhem sLlll because Lhls wlll mlnlmlze Lhe rlsk of
lnfecLlon (3) 1lghLen up Lhe screws several Llmes durlng Lhe flrsL 24 hours Lhen don'L LlghLen Lhem anymore uon'L LlghLen
Lhem unnecessarlly or Lhey may perforaLe hls lnner Lable (4) lf Lhe LracLlon slLes become lnfecLed move Lhe plns on Lhe halo

LC 9LLvlC 18C1lCn scollosls


LC lLMC8L 18C1lCn severe scollosls

SluL 8M 18C1lCn supracondylar fracLure humerus shoulder


CvL8Lu 18C1lCn supracondylar affecLaLlon of Lhe humerus

uunLC9 18C1lCn supracondylar fracLure of humerus
(skln LracLlon)


MMCCk SuS9LnSlCn 18C1lCn pelvls reglon
affecLaLlon


9LLvlC Cl8uLL 18C1lCn lumbo sacral affecLaLlon of Lhe
splne such as n9 low back syndrome


CC18LL 18C1lCn(ead halLer + pelvlc glrdle) non
adheslve lumbar affecLlon severe cervlcal spraln cervlcal
sLraln LorLlcollls mlld cervlcal Lrauma poLL's dlsease



9090uLC8LLS 18C1lCn dlsplaced subrochanLerlc of
Lhe lesser LrochanLer


8?n1 18C1lCn fracLure of hlp and femur ln[urles Lo
Lhe hlp among chlldren before 3 y/o aL paLlra poslLlon
(skln LracLlon)

uCkS Lx1LnSlCn 18C1lCn affecLlon of hlp and femur
lower exLremlLles for 3y/o and above


CC1 CS1 18C1lCn ankle meLaLarsal fracLure posL
pollomyellLls wlLh resldual paralysls










back brace ls a devlce deslgned Lo llmlL Lhe moLlon of Lhe splne ln cases of fracLure or ln posLoperaLlve fuslons LlmlLlng Lhe
moLlon of Lhe splne enhances Lhe heallng process and mlnlmlzes Lhe paLlenLs dlscomforL
Common back braces lnclude
O k|g|d (nard) braces 1hese braces are formflLLlng plasLlc molds LhaL resLrlcL moLlon by as much as 30 and
O Soft braces LlasLlc braces LhaL llmlL forward moLlon of Lhe splne and asslsL ln seLLlng splnal fuslons or supporLlng Lhe
splne durlng occaslons of sLress (for example employmenL requlrlng Lhe llfLlng of heavy loads)

1LS CI SCCLICSIS 8kACLS

1C8CCLuMCSC8LC81CSlS (1LSC) mosL common CS1Cn 8CL
lL may be referred Lo as an underarm" brace 1hls brace ls flLLed Lo Lhe chlld's body and cusLom molded from plasLlc lL works
by applylng LhreepolnL pressure Lo Lhe curvaLure Lo prevenL lLs progresslon
lL correcLs curvaLure by pushlng wlLh small pads placed agalnsL Lhe rlbs whlch are also used for roLaLlonal correcLlon 1hese
pads are usually placed ln Lhe back corners of Lhe brace so LhaL Lhe body ls LhrusL forward agalnsL Lhe braces fronL whlch acLs
Lo hold Lhe body uprlghL 1he brace opens Lo Lhe back and usually runs from [usL above a chalrs seaL (when a person ls seaLed)
Lo around shoulderblade helghL ecause of Lhls lL ls noL parLlcularly useful ln correcLlng very hlgh curves lL also does noL
correcL hlp mlsallgnmenL as lL uses Lhe hlps as a base polnL 1hls brace ls Lyplcally worn 2023 hours a day

CL8vlCC1C8CCLuMCSC8LC81CSlS (known as a MlLWukLL 8CL)
1he Mllwaukee brace ls slmllar Lo Lhe 1LSC descrlbed above buL also lncludes a neck rlng held ln place by verLlcal bars aLLached
Lo Lhe body of Lhe brace

lL ls a largely symmeLrlcal brace 1he brace ls made wlLh a harnessllke hlp area and meLal sLrlps rlslng Lo Lhe chln where a
collar ls eLween Lhe hlps and chln Lhere are correcLlve LhrusLs glven wlLh large pads 1here ls llLLle roLaLlonal correcLlon
1oday Lhls brace ls generally used for very hlgh Lhoraclc curves LhaL are severe and ouL of range of Lhe osLon 1hls brace ls
Lyplcally worn 2023 hours a day

C8LLS1Cn LnulnC 8CL (also known as nlghL Llme" brace) lL ls only worn whlle sleeplng CharlesLon back brace ls
molded Lo Lhe paLlenL whlle Lhey are benL Lo Lhe slde and Lhus applles more pressure and bends Lhe chlld agalnsL Lhe curve
1hls pressure lmproves Lhe correcLlve acLlon of Lhe brace

1hls brace was deslgned wlLh Lhe ldea LhaL compllance would lncrease lf Lhe brace were worn only aL nlghL lL ls asymmeLrlcal
1he brace flghLs agalnsL Lhe bodys curve by overcorrecLlng lL grlps Lhe hlps much llke Lhe osLon and rlses Lo approxlmaLely
Lhe same helghL buL pushes Lhe paLlenLs body Lo Lhe slde lL ls used ln slngle Lhoracolumbar curves ln paLlenLs 1214 years of
age (before sLrucLural maLurlLy) who have flexlble curves ln Lhe range of 2333 Cobb degrees

S9lnLCC8 8CL 1hls ls Lhe only wldelyused sofL brace currenLly 1he brace has a pelvlc unlL from whlch sLrong elasLlc bands
wrap around Lhe body pulllng agalnsL curves roLaLlons and lmbalances lL ls mosL successful when Lhe paLlenL has relaLlvely
small and slmple curvaLures ls sLrucLurally young and compllanLlL ls usually worn 20 hours a day 1he paLlenL ls noL Lo have lL
off for more Lhan Lwo hours aL a Llme Whlle lL ls expecLed LhaL paLlenLs can parLlclpaLe ln acLlvlLles as sLrenuous as compeLlLlve
gymnasLlcs whlle ln brace lL also pulls down agalnsL shoulder mlsallgnmenLs whlch compresses Lhe splne LongLerm resulLs are
also largely ln Lhe maklng Splnecor ls also Lhe only scollosls brace for adulLs


SCMl CL8vlCL C81CSlS (S1L8nC CCCl9l1C MnuluL8 lMMClLlZ1lCn 8CL)
a rlgld cervlco Lhoraclc orLhosls used for supporLlng Lhe cervlcal splne SCMl does noL provlde compleLe lmmoblllzaLlon
Lhough lL ls somewhere beLween a 9hlladelphla collar and a halo brace
SLrucLurally lL has a chesL plaLe LhaL goes up Lo Lhe noLch where Lhe collarbones meeL ln Lhe fronL and meLal alumlnum or
plasLlc bars LhaL curve over Lhe shoulder
SLraps from Lhe bars go over Lhe shoulder and cross Lo Lhe opposlLe slde of Lhe anLerlor plaLe Lo hold lL ln place
removable chln plece aLLaches Lo Lhe chesL plaLe wlLh an opLlonal headplece LhaL can be used when Lhe chln plece ls
removed for eaLlng
1he SCMl works well Lo conLrol flexlon of Lhe upper cervlcal splne (C13) lL does noL conLrol exLenslon LhaL well
1he SCMl ls used Lo lmmoblllze an unsLable neck due Lo fracLure or llgamenLous ln[ury or dlsrupLlon


8CnLLk 8kAD- SLI-1 (88 SLI-1) lL ls a common spllnL used ln wards for lmmoblllzaLlon and reducLlon of lower llmb
fracLures and LreaLmenL of oLher lower llmb paLhologles
Structure
lL conslsLs of an lron frame wlLh a seL of 4 pulleys for appllcaLlon of moblle LracLlon lL ls modlfled from raun spllnL whlch
conslsLs of only one pulley

Dses of 4 pu||eys
LowermosL 1lbla and flbula ln[urles
Second from boLLom supracondylar fracLure femur
3rd (dlrecLed away from paLlenL) fracLure shafL femur mlddle Lhlrd
4Lh (LopmosL and dlrecLed Lowards Lhe paLlenL) prevenLs fooL drop

W|th tract|on
lor lower llmb ln[urles wlLh dlsplacemenL / fragmenL overlap 1he skeleLal fracLlon ls glven vla a k wlre SLelnmam pln ohlers
pln eLc
ln leg fracLure pln Lhrough calcaneal LuberoslLy
ln femur fracLure pln Lhrough Llblal LuberoslLy ln adulLs [usL above condyles ln chlldren
W|thout tract|on
Compound fracLure wlLh no overlap for dresslng and wound cafe and posslble lmmoblllzaLlon
SofL Llssue ln[ury Lo leg
8esL ln case of cellullLls gangrene ampuLaLlon eLc

Advantages
Moblle fracLlon
Llmb ln comforLable poslLlon
Wound care posslble
MulLlpurpose appllcaLlon

D|sadvantages comp||cat|ons
non ambulaLory
SLlffness / conLracLure
urlnaLlon and defecaLlon becomes dlfflculL
Common peroneal nerve compresslon
CLher compllcaLlons as ln l1 spllnL and LracLlon










Mllwaukee Scollosls above Lhoraclc 9 ?amamoLo scollosls below Lhoraclc 9