Академический Документы
Профессиональный Документы
Культура Документы
Matt Leiszler, MD
Stephanie Chu, DO
Jack Spittler, MD
Other Fractures:
Radius and ulna
Carpal
Ulna
Humerus
Tibia
Tarsal
Casting and
Splinting
Overview
Mainstay of treatment for most fractures
Joint above and a joint below
Avoid pressure points
– Excessive molding
– Cast indentations
Appropriate padding
– More at bony prominence
– Not too much at fracture site
Consider skin wounds
Splinting
Splinting
Purpose
Reduce pain
Reduce bleeding and swelling
Prevent further soft tissue damage
Prevent vascular constriction
What to splint
Fracture
Dislocation
Tendon rupture
Specific splints
Jones Fracture
Supplies
Stockinette
Padding material
Cast material
– Plaster: cheaper, long shelf life, easier to
work with
May be fragile, disintegrate in water
– Fiberglass: more durable, lighter, dry quicker,
multiple colors, water tolerant
– Newer synthetic materials
Procedure
Apply stockinette
– Protect skin and provide smooth edge
Apply padding
– Protect bony prominence
– Allows for swelling
Wet the casting material
– Hot water hardens faster
– Squeeze out excess water
Apply splint or cast
Patient Education
Keep injured limb elevated and iced
Warning signs
– Numb extremity
– Inability to move extremity
– Discoloration, Cold
– Increased pain
Avoid getting wet
– Completely with plaster
– May use hair dryer on cool setting if fiberglass
Patient Education
Cast saw
Vibrates, doesn’t rotate
Biggest concern is burn
Take Home Points