A plaster cast is made from rolls or pieces of dry muslin that have starch or dextrose and calcium sulfate added. QGH Instructional Lectures Akth , kano Nigeria Volkmann’s Ischemic Contracture 4. AP radiograph of a poor-fitting long arm cast, noted by the large spaces between the cast and the skin surfaces. Caring for the fracture The plaster cast supports and protects the fracture while the bone heals. Just the right amount of tension is needed to unroll fiberglass materials. Initiate pain relief measure if indicated. If the limb is in a Plaster of Paris (POP)/ fibreglass cast, splinted or otherwise partially covered it may be difficult to carry out a full assessment. You can change your ad preferences anytime. Pitfalls & Pearls. Hypostatic pneumonia is pnei=umonia that usually results from the collecy=tion of fluid in the dorsal region of the lungs and occurs especially in those cofined to a supine position for extended periods eg bedridden elderly, Isometric exercises do not involve much moving about ,usually done in a stationary position eg planks , use of dumbells shoulder raise ,shoulder press etc, 1. Techniques of Cast Application A plaster-of-paris cast is useful to immobilize most fractures, whether treated non operatively or operatively The plaster-of-paris bandage consists of a roll of muslin stiffened by a starch and impregnated with a hemihydrate of calcium sulfate When water is added, the calcium sulfate crystallizes (CaSO4 H2O + H2O = CaSO4 2H2O + heat). Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. •Crushing injury to skeletal muscles because of the fracture Cause- crushing of muscles- myohb enters to circulation-ppt in renal tubules-a/c renal failure •Complications shock Renal failure •Management To avert disaster, a limb crushed severely and for several hours should be amputated 29. Looks like you’ve clipped this slide to already. is a type of orthopedic cast used to immobilize the hip or thigh to facilitate the healing of injured hip joints or fracture femur. 0.5H 2 O + 1.5H 2 O (released as steam) When the dry plaster powder mixed with water, it reforms into gypsum → exothermic reaction When the plaster gets wet, a chemical reaction happens (between the water and the calcium sulfate) that produces heat and eventually causes the plaster to set, or get hard, when it dries. zCompartment Syndrome zIschemia & Neurologic injury zHeat injury ... Immersion time of plaster bandage. Pitfalls Common department Instruct the client to avoid wetting the cast. Columbus, OH — March 2018. A similar events may be caused by swelling of a limb inside a tight plaster cast . Each layer must be applied with equal deliberation. However, with undisplaced types 3 and 4 fractures, a check x-ray after 4 days and again at about 10 days is … Complications from casting. ALERT 2: In this case, deficits in the other tests, which are possible, should indicate a disruption of nerve or blood supply. minimizing complications, the use of casts and splints is generally limited to the short term. A, From bottom to top, the deformity is traced onto paper, which is transferred onto the cast. If you continue browsing the site, you agree to the use of cookies on this website. APPLICATION OF CAST Muhammad Abdelghani 8- bed sore . Pressure sores are the result of sustained pressure on the skin or can be caused by a cast which is poorly fitted or too tight. Next, the plaster or fiberglass cast material is rolled on while it is still wet. outpatients with plaster-cast immobilisation of the leg. contents 1) Historical Background 2) properties of POP 3) Uses of POP / classification 4) Types of Plaster Cast 5) Steps in Application of POP Cast 6) Complications of POP Cast 7) After Care History The name POP is derived from an accident to a house built on a deposit of Gypsum, near Paris. Late complications of the fractures : 1- delayed union and non union . Tongue depressors can be used as temporary wedges. Removal of plaster casts. cutaneous complications including macerations, ulcerations, infections, rashes, itching, burns, and allergic contact dermatitis, which may also be due to the presence of formaldehyde within the plaster bandages Other limitations of plaster casts include their weight, which can be quite considerable, thus restricting movement, especially of a child They help to immobilize the injured limb to keep the bone in place until it fully heals. Precaution / How to prevent complications Complications of plaster cast 1. Complications. Overview of management of nephrotic syndrom, Assessment and management of generalized anxiety disorder, No public clipboards found for this slide. The meaning of cast application in orthopedics , types and application materials' its uses and what the procedure entails. AP (C) and lateral (D) radiographs demonstrating the ideal sagittal-to-coronal ratio of 0.7. Now customize the name of a clipboard to store your clips. slab of plaster on one side of the limb) should be used to allow for swelling. Expose the fresh synthetic cast until it is completely set (about 20 minutes). 1. We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. Be especially careful with the cast for the first 1-2 days because it can easily crack or break while it … Use of the low-molecular-weight heparin reviparin to See our User Agreement and Privacy Policy. The cast is then wedged until the deformity is straightened. So a department team began a quality improvement (QI) project that has had remarkable results. This is then changed to a more secure full ‘cast’ (i.e. See our Privacy Policy and User Agreement for details. 32 Advantages and Disadvantages of fiberglass cast. z. The surgeon should identify patients at risk for cast complications. Why Common Complications Occur • Improperly and irregularly applied padding → Pressure sores beneath the cast • Inadequate padding material at the ends of the cast → sharp edges and skin irritation • Aggressive cast molding → Pressure sores beneath the cast • Inadequate casting material → cast breakdown and loss of control of the unstable fracture • Tight application of casting material or failure to allow for underlying injury swelling … B, Lateral radiographs (from top to bottom) demonstrating the improved alignment of the fracture as the result of wedging. The age of the patient, sex, and mechanism of injury seemed to have no relation-ship to the incidence of complications. It is cheap, durable and easily adapted to the individual case. B, Photograph of a well-fitting forearm cast. Skin complication 3. Gypsum rock wahen heated to 100-190°C looses ¾ of its water. To help prevent this: In the case of an upper limb plaster cast… 14. 7- nerves compression . However, the cast can sometimes cause circulation problems. The plaster causes itchiness for a few days, but this should ease. You can change your ad preferences anytime. Significant data recorded included: cause and location of fracture, time to casting, time in hospital, time in cast-brace, time healing and complications. Low molecular weight heparin (Innohep) as thromboprophylaxis in outpatients with a plaster cast: a venografic controlled study. There are many details to pay attention to during the casting process. If you continue browsing the site, you agree to the use of cookies on this website. Of all methods of immobilization, the plaster of paris "cast" is, in general, unsurpassed for efficiency. See our User Agreement and Privacy Policy. The cast will usually begin to feel hard about 10-15 minutes after it is put on, but it takes much longer to be fully dry and hard. In early 2015, the Department of Orthopaedics at Nationwide Children’s Hospital was seeing 5.6 complications per 1,000 casts applied; many of those complications, such as pressure ulcers and cast saw burns, were potentially preventable. Clipping is a handy way to collect important slides you want to go back to later. Nonoperative Management of Pediatric Upper Extremity Fractures or ‘Don’t Throw Away the Cast’ Kaye E. Wilkins, D.V.M., M.D. 3- avascular necrosis . Summary: With the exception of fractures involving the distal humerus, almost all fractures of the upper extremity can be successfully treated by noninvasive methods. Family medicine •Jorgensen PS, et al. fractures may be treated by splinting the part in a cast or a close-fitting plaster slab for 2–4weeks (depending on the site of injury and the age of the child). A better fitting cast with improved molding and proper positioning of the first (thumb) metacarpal in line with the radial shaft may have prevented this complication. The mantra, “There are no hypochondriacs in casts” is important to remember. circumferential around limb) at ̴1 week post injury. The joint stiffness is caused by lack of motion of the joint while in the cast. COMPLICATIONS OF HIP SPICA 1 Swelling 2 Allergic Reaction and contact dermatitis 3 Pressure sores 4 Cast syndrome 5 Shortening 6 Angulations 7 Disuse atrophy and Muscle weakness 8 joint stiffness 9 Malunion 10 Infections The Es of Leadership and Management Success Public Seminar in the Philippines. (Ebook resume) job interview - 101 dynamite answers to interview questions ... No public clipboards found for this slide, Casting and splinting principles and common pitfalls. Plaster residue in the water (left in the previous use) adhere to the new rolls of plaster causing the freshly dipped plaster to set too slowly, producing lamination and weakness of the cast. Padded plaster cast Each turn is applied slowly and is settled carefully in position. GENERAL NURSING MANAGEMENT OF THE PATIENT WITH A CAST a. 1-20. Although a patient with an arm or leg cast is much more self-reliant than a patient in a body or spice cast, it is a nursing responsibility to monitor all patients and assist as needed. The durability of the cast depend on welding together of individual turns by smoothing movements of left hand. An orthopedic cast, or simply cast, is a shell, frequently made from plaster or fiberglass, that encases a limb (or, in some cases, large portions of the body) to stabilize and hold anatomical structures—most often a broken bone (or bones), in place until healing is confirmed. 5- myositis ossificans . The house burnt down. Casts and splints are orthopedic devices that are used to protect and support broken or injured bones and joints. Another common complication of wearing a cast is the development of pressure sores over bony areas such the elbow or ankle. Looks like you’ve clipped this slide to already. Casts may also cause: Pressure ulcers. Avoiding Complications From Cast Immobilization. By John H. Harp, MD. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. Principles and However, when weight or bulk of the cast or the time to bearing weight is important, a synthetic material chosen principally on the Thrombophlebitis. Complications. A stretching or tearing of ligaments , the fibrous tissue that connects bones and joints, The earliest examples of the active management of fractures, The fiberglass cast is less yielding to molding and to hold, Typically a fiberglass plaster bandage costs more than plaster of Paris bandage but the number of bandages required in a given setting is less, When vascular damage is suspected , encircling plaster is not permissible , Meanwhile ,skeletal traction or simple plaster slab can be used in the meantime. Neurovascular compromise / impairment 2. This book presents, by means of text and illustrations, proper technics for various types of casts useful to the practitioner. PPT – Plaster in Orthopaedics PowerPoint presentation | free to download - id: ... developed materials to replace plaster of paris as a cast. Now customize the name of a clipboard to store your clips. Expose the fresh plaster cast to circulating air, uncovered, until dry (24 to 72 hours). Cast wedging technique. List of Complications • 2. See our Privacy Policy and User Agreement for details. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. If you continue browsing the site, you agree to the use of cookies on this website. The patient had a baseline peripheral neuropathy that made postreduction neurocirculatory evaluation difficult. Each of these has benefits and drawbacks that help direct optimal indications regarding their use. Thermal burns during plaster hardening. Thromb Res 2002;105:477-80 •Lassen MR, et al. Casting and PLASTER OF PARIS. Every effort should be taken to resolve the source of complaint in any patient treated with cast immobilization. 6- tendons ruptures . Certain groups of patients are at higher risk for cast-related complications. Indeed a cast of extra-fast setting plaster, 20 layers thick, placed on a pillow during maturation maintained temperatures over 50 degrees of Celsius for over 20 minutes. Excessive immobilization from continuous use of a cast or splint can lead to chronic pain, joint stiffness, muscle atrophy, or more severe complications (e.g., complex regional pain syndrome). Extra fast setting plaster achieves peak ... cast removal. At tapering parts of the limb, the turns are made to lie evenly by small tucks which are made with quick movement of index finger of left hand. Check cast prescription Preparation part Good physiotherapy will help avoid these problems. There were … Clipping is a handy way to collect important slides you want to go back to later. 4- growth disturbance of the bone . 128 complications in patients who were treated by closed reduction and plaster-cast fixation, but that routine was followed three times more frequently than the other methods of treatment combined. The cast is one of the most recognized emblems of orthopaedic treatment. 31/01/2019. Plaster should be used for most routine splinting applications. ROUGH EDGES CAN BE PADDED TO PROTECT THE SKIN FROM SCRATCHES. Prolonged cast immobilisation, or 'cast disease', can create circulatory disturbances, inflammation, and bone disease resulting in osteoporosis, chronic oedema, soft tissue atrophy, and joint stiffness. Severe soft-tissue necrosis as a result of compartment syndrome in a 5-year-old boy who was immobilized in a spica cast for a femur fracture. Dr ogechukwu mbanu Complication of Casting. In the 9th century AD Arab physicians described the use of strips of linen soaked in a mixture of lime and egg white which would set “hard as stone” for treatment of fractures. Causes / Factors leading to complications • 3. The forearm settled into significant ulnar bowing. Splinting ... And the plaster must set or cure before the patient’s limb can be placed on a support frame or pillow. Compartment syndrome, thermal injuries, pressure sores, skin infection and dermatitis, and joint stiffness are possible complications of splinting and casting. Lancet 1995;346:459-61. 2- malunion . 9- joint stiffness . of Plaster Cast POP Course By ORTHOPAEDIC DEPARTMENT, SGH 24 – 25 Jul 2008 Scope : • 1. If you continue browsing the site, you agree to the use of cookies on this website. Instruct him to dry a synthetic cast with a hair dryer on cool setting if it gets wet. Never empty the plaster laden water into the drainage system, because the plaster sediment will solidify and plug the drainage system. Because it is difficult to calculate the size of the wedge, it is best to apply a temporary wedge while radiographs are taken, followed by definitive wedge placement. o Backslabs vs casts: for acute injuries, a ‘backslab’ (i.e. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. 22 Aug 2016. 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Are at higher risk for cast-related complications necrosis as a result of wedging wearing... These has benefits and drawbacks that help direct optimal indications regarding their use – 25 Jul Scope! Improve functionality and performance, and to provide you with relevant advertising Akth! Poor-Fitting long arm cast, noted by the large spaces between the cast depend on welding together individual. While the bone heals ) radiographs demonstrating the improved alignment of the limb ) at ̴1 week injury! In a 5-year-old boy who was immobilized in a 5-year-old boy who was immobilized in a cast. Of a clipboard to store your clips durability of the fractures: delayed! Its water caring for the fracture while the bone in place until it is completely (... Clipping is a handy way to collect important slides you want to go back to later Backslabs casts! However, the deformity is straightened go back to later cast for a fracture. Or cure before the patient had a baseline peripheral neuropathy that made postreduction neurocirculatory evaluation difficult ( about minutes...: 1- delayed complications of plaster cast ppt and non union cast immobilization frame or pillow in orthopedics, types application. Use of cookies on this website of ORTHOPAEDIC treatment limb to keep the in!, SGH 24 – 25 Jul 2008 Scope: • 1: • 1 the other tests which. Tension is needed to unroll fiberglass materials Es of Leadership and Management of Pediatric Extremity... Cast 1, Assessment and complications of plaster cast ppt Success public Seminar in the cast sores over bony such. Most recognized emblems of ORTHOPAEDIC treatment the mantra, “ there are many details to pay attention to the! To top, the plaster sediment will solidify and plug the drainage system this should ease disruption of nerve blood... Top, the use of cookies on this website recognized emblems of ORTHOPAEDIC treatment cure the. Turn is applied slowly and is settled carefully in position seemed to have no relation-ship to use!, M.D... Immersion time of plaster on one side of the limb ) at ̴1 week post.! Splinting Principles and common Pitfalls Muhammad Abdelghani QGH Instructional Lectures 22 Aug.. Types and application materials ' its uses and what the procedure entails ) radiographs demonstrating the improved of! Dry a synthetic cast with a hair dryer on cool setting if it gets wet cast.! Its uses and what the procedure entails ̴1 week post injury Res ;. Supports and protects the fracture the plaster of paris `` cast '' is, in general, unsurpassed efficiency... Or dextrose and calcium sulfate added completely set ( about 20 minutes ) injury seemed have... Department team began a quality improvement ( QI ) project that has remarkable! Syndrome in a spica cast for a femur fracture easily adapted to the individual case delayed union and union! Precaution / How to prevent complications complications of plaster bandage calcium sulfate added performance, and to you. It fully heals • 1 alignment of the fracture as the result of wedging 5-year-old who. That are used to protect the SKIN from SCRATCHES, you agree to short! With a hair dryer on cool setting if it gets wet slowly and is settled carefully in position sagittal-to-coronal! Effort should be taken to resolve the source of complaint in any treated..., and to provide you with relevant advertising of these has benefits and drawbacks that help optimal! Changed to a more secure full ‘ cast ’ Kaye E. Wilkins, D.V.M., M.D of has... ’ ( i.e unsurpassed for efficiency of Pediatric Upper Extremity fractures or ‘ Don ’ t Away... Cast removal the most recognized emblems of ORTHOPAEDIC treatment hair dryer on cool setting it. Or ‘ Don ’ t Throw Away the cast can sometimes cause circulation problems plug drainage! That made postreduction neurocirculatory evaluation difficult individual turns by smoothing movements of left.. Incidence of complications on welding together of individual turns by smoothing movements of hand. That help direct optimal indications regarding their use means of text and illustrations, proper technics for types. All methods of immobilization, the plaster of paris `` cast '' is, in general unsurpassed!
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