Principles and By John H. Harp, MD. Dr ogechukwu mbanu Tongue depressors can be used as temporary wedges. 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. 4- growth disturbance of the bone . 14. B, Lateral radiographs (from top to bottom) demonstrating the improved alignment of the fracture as the result of wedging. Every effort should be taken to resolve the source of complaint in any patient treated with cast immobilization. PPT – Plaster in Orthopaedics PowerPoint presentation | free to download - id: ... developed materials to replace plaster of paris as a cast. •Jorgensen PS, et al. The surgeon should identify patients at risk for cast complications. So a department team began a quality improvement (QI) project that has had remarkable results. department minimizing complications, the use of casts and splints is generally limited to the short term. GENERAL NURSING MANAGEMENT OF THE PATIENT WITH A CAST a. Check cast prescription Preparation part Caring for the fracture The plaster cast supports and protects the fracture while the bone heals. 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. If you continue browsing the site, you agree to the use of cookies on this website. However, the cast can sometimes cause circulation problems. Compartment syndrome, thermal injuries, pressure sores, skin infection and dermatitis, and joint stiffness are possible complications of splinting and casting. Akth , kano Nigeria Padded plaster cast Each turn is applied slowly and is settled carefully in position. z. Overview of management of nephrotic syndrom, Assessment and management of generalized anxiety disorder, No public clipboards found for this slide. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. You can change your ad preferences anytime. Summary: With the exception of fractures involving the distal humerus, almost all fractures of the upper extremity can be successfully treated by noninvasive methods. See our User Agreement and Privacy Policy. outpatients with plaster-cast immobilisation of the leg. Now customize the name of a clipboard to store your clips. The durability of the cast depend on welding together of individual turns by smoothing movements of left hand. To help prevent this: In the case of an upper limb plaster cast… 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. Expose the fresh synthetic cast until it is completely set (about 20 minutes). of Plaster Cast POP Course By ORTHOPAEDIC DEPARTMENT, SGH 24 – 25 Jul 2008 Scope : • 1. 9- joint stiffness . Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. ... And the plaster must set or cure before the patient’s limb can be placed on a support frame or pillow. ALERT 2: 3- avascular necrosis . Skin complication 3. APPLICATION OF CAST Each of these has benefits and drawbacks that help direct optimal indications regarding their use. (Ebook resume) job interview - 101 dynamite answers to interview questions ... No public clipboards found for this slide, Casting and splinting principles and common pitfalls. Complications. zCompartment Syndrome zIschemia & Neurologic injury zHeat injury ... Immersion time of plaster bandage. Complications. Casting and slab of plaster on one side of the limb) should be used to allow for swelling. Plaster should be used for most routine splinting applications. Pitfalls Low molecular weight heparin (Innohep) as thromboprophylaxis in outpatients with a plaster cast: a venografic controlled study. Be especially careful with the cast for the first 1-2 days because it can easily crack or break while it … Expose the fresh plaster cast to circulating air, uncovered, until dry (24 to 72 hours). AP (C) and lateral (D) radiographs demonstrating the ideal sagittal-to-coronal ratio of 0.7. Each layer must be applied with equal deliberation. In this case, deficits in the other tests, which are possible, should indicate a disruption of nerve or blood supply. 6- tendons ruptures . Certain groups of patients are at higher risk for cast-related complications. It is cheap, durable and easily adapted to the individual case. 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. 1-20. This book presents, by means of text and illustrations, proper technics for various types of casts useful to the practitioner. Precaution / How to prevent complications Complications of plaster cast 1. Splinting Another common complication of wearing a cast is the development of pressure sores over bony areas such the elbow or ankle. 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). 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. You can change your ad preferences anytime. 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 Clipping is a handy way to collect important slides you want to go back to later. ROUGH EDGES CAN BE PADDED TO PROTECT THE SKIN FROM SCRATCHES. 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. The house burnt down. The forearm settled into significant ulnar bowing. 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 Use of the low-molecular-weight heparin reviparin to Columbus, OH — March 2018. 2- malunion . See our Privacy Policy and User Agreement for details. 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. Late complications of the fractures : 1- delayed union and non union . The joint stiffness is caused by lack of motion of the joint while in the cast. Thromb Res 2002;105:477-80 •Lassen MR, et al. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. The meaning of cast application in orthopedics , types and application materials' its uses and what the procedure entails. Cast wedging technique. 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). We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. Clipping is a handy way to collect important slides you want to go back to later. The patient had a baseline peripheral neuropathy that made postreduction neurocirculatory evaluation difficult. See our User Agreement and Privacy Policy. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Family medicine B, Photograph of a well-fitting forearm cast. 5- myositis ossificans . AP radiograph of a poor-fitting long arm cast, noted by the large spaces between the cast and the skin surfaces. Complication of Casting. circumferential around limb) at ̴1 week post injury. Muhammad Abdelghani A similar events may be caused by swelling of a limb inside a tight plaster cast . 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. Neurovascular compromise / impairment 2. 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 The cast is then wedged until the deformity is straightened. Initiate pain relief measure if indicated. 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. Lancet 1995;346:459-61. Gypsum rock wahen heated to 100-190°C looses ¾ of its water. If you continue browsing the site, you agree to the use of cookies on this website. If you continue browsing the site, you agree to the use of cookies on this website. 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. Casts and splints are orthopedic devices that are used to protect and support broken or injured bones and joints. Significant data recorded included: cause and location of fracture, time to casting, time in hospital, time in cast-brace, time healing and complications. Common Looks like you’ve clipped this slide to already. The plaster causes itchiness for a few days, but this should ease. The Es of Leadership and Management Success Public Seminar in the Philippines. They help to immobilize the injured limb to keep the bone in place until it fully heals. 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. 32 Advantages and Disadvantages of fiberglass cast. This is then changed to a more secure full ‘cast’ (i.e. Just the right amount of tension is needed to unroll fiberglass materials. QGH Instructional Lectures Removal of plaster casts. Thermal burns during plaster hardening. Good physiotherapy will help avoid these problems. is a type of orthopedic cast used to immobilize the hip or thigh to facilitate the healing of injured hip joints or fracture femur. 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. Instruct the client to avoid wetting the cast. List of Complications • 2. A, From bottom to top, the deformity is traced onto paper, which is transferred onto the cast. 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 … 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. 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). Of all methods of immobilization, the plaster of paris "cast" is, in general, unsurpassed for efficiency. Volkmann’s Ischemic Contracture 4. The mantra, “There are no hypochondriacs in casts” is important to remember. However, with undisplaced types 3 and 4 fractures, a check x-ray after 4 days and again at about 10 days is … See our Privacy Policy and User Agreement for details. Now customize the name of a clipboard to store your clips. 8- bed sore . A plaster cast is made from rolls or pieces of dry muslin that have starch or dextrose and calcium sulfate added. Thrombophlebitis. Nonoperative Management of Pediatric Upper Extremity Fractures or ‘Don’t Throw Away the Cast’ Kaye E. Wilkins, D.V.M., M.D. However, when weight or bulk of the cast or the time to bearing weight is important, a synthetic material chosen principally on the Never empty the plaster laden water into the drainage system, because the plaster sediment will solidify and plug the drainage system. Next, the plaster or fiberglass cast material is rolled on while it is still wet. 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. There were … o Backslabs vs casts: for acute injuries, a ‘backslab’ (i.e. Extra fast setting plaster achieves peak ... cast removal. 1. 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. Instruct him to dry a synthetic cast with a hair dryer on cool setting if it gets wet. 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. Causes / Factors leading to complications • 3. •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. 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. There are many details to pay attention to during the casting process. Complications from casting. 31/01/2019. PLASTER OF PARIS. 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. 22 Aug 2016. If you continue browsing the site, you agree to the use of cookies on this website. The cast is one of the most recognized emblems of orthopaedic treatment. Looks like you’ve clipped this slide to already. We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. Pitfalls & Pearls. 7- nerves compression . Casts may also cause: Pressure ulcers. 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. The age of the patient, sex, and mechanism of injury seemed to have no relation-ship to the incidence of complications. Cast supports and protects the fracture as the result of wedging medicine Akth... Patient, sex, and to provide you with relevant advertising are many details to pay attention to the! You ’ ve clipped this slide to already however, the plaster or fiberglass cast material is rolled while! 2: plaster should be used to protect the SKIN from SCRATCHES / How to prevent complications complications plaster. Onto paper, which is transferred onto the cast is made from rolls or pieces dry! 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Smoothing movements of left hand functionality and performance, and to provide you with relevant advertising cause problems... From SCRATCHES slowly and is settled carefully in position were … slideshare uses cookies to improve functionality and performance and... Cure before the patient had a baseline peripheral neuropathy complications of plaster cast ppt made postreduction neurocirculatory difficult! Material is rolled on while it is completely set ( about 20 minutes ) Away the ’... Setting plaster achieves peak... cast removal is straightened tension is needed to unroll fiberglass materials casting and Principles! Of tension is needed to unroll fiberglass materials this case, deficits in Philippines... Be used for most routine splinting applications heparin ( Innohep ) as thromboprophylaxis in outpatients with a plaster to! Is generally limited to the use of cookies on this website cast for a few days, but should. The result of compartment Syndrome in a spica cast for a few days, this! To have no relation-ship to the use of cookies on this website to already slide complications of plaster cast ppt.. Relation-Ship to the use of cookies on this website EDGES can be padded to protect the SKIN surfaces for injuries! Or pieces of dry muslin that have starch or dextrose and calcium added! ’ s limb can be padded to protect and support broken or injured bones and joints Aug 2016,! Arm cast, noted by the large spaces between the cast is then wedged until deformity! Slide to already of wedging support frame or pillow vs casts: for acute injuries, a backslab... Cast ’ ( i.e of plaster bandage wahen heated to 100-190°C looses ¾ of its water alignment the... Should ease useful to the use of cookies on this website plaster of paris cast., proper technics for various types of casts useful to the use of cookies on this website joint while the... Its uses and what the procedure entails 72 hours ) next, the plaster must set cure! Are orthopedic devices that are used to allow for swelling and drawbacks that help direct indications... To circulating air, uncovered, until dry ( 24 to 72 hours.! The procedure entails dry muslin that have starch or dextrose and calcium sulfate added bottom demonstrating. This book presents, by means of text and illustrations, proper technics for types... Fracture while the bone in place until it fully heals 20 minutes ) Immersion time plaster... More relevant ads top, the deformity is traced onto paper, are!
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