cast immobilisation

7/31/2019 Cast Immobilisation

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CAST IMMOBILISATION


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Immobilization of fracture

Indication:

To prevent displacement or angulation offracture

To prevent movemet that might infere withunion

To relieve pain


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Conservative method

Strapping

Sling

Cast immobilization- using plaster of paris


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Plaster of Paris is Gypsum salt ( dry form)

2 (CaSO4 H2O) + 3 H2O 2 (CaSO4.2H2O)+ Heat[1]

The setting of unmodified plaster starts about10 minutes after mixing and is complete inabout 45 minutes; however, the cast is notfully dry for 72 hours.[2]
http://en.wikipedia.org/wiki/Gypsumhttp://en.wikipedia.org/wiki/Gypsum


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History

3000 B.C. when crude splints wereconstructed from bark and palm ribs and heldtogether by gum, egg whites, goat's wool,clay and plaster

860 A.D., an Arabian physician mixed limewith egg whites, to create a hard mixture

16th century, doctors in the Turkish Empire

covered broken bones in gypsum, leavingopenings for plugs of wood and greased cork.When the cast dried, the plugs were removedto allow ventilation and outlets for swelling.Once the swelling decreased, liquid gypsum

filled in the holes.


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FINALLY

"Plaster of Paris," named after the plasterdeposits near the French capital, wasdeveloped a few years later.

plaster molds attached to the injury via anelaborate array of bandages. By 1852,"Plaster of Paris" powder was rubbed intocotton bandages that were then soaked inwater and applied directly to the limb.

Although this cast had to be kept dry, and wasstill heavy and burdensome for patients towear, "Plaster of Paris" bandages remainedthe standard casting material for more then

one hundred years.


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Usage of POP

1) SLAB

Cover a part of circumference of the limb

2) CAST

-- Cover the whole circumference of the limb


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Plaster cast & their uses


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Principle when applying plaster cast

1) immobilize joint above and below fracture

2) immobilize in functional position

Pad limb adequtelyesp, bony prominent

Mobilize joints that not included in plaster


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Application of plaster cast

1) Protect the skin

-stockinggete

-facilicate conduction of

perspiration

-protect skin from rough

plaster edge

-wool roll

-protect bony prominent

-felt

-prevent friction over body


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2) wetting plaster bandages

-immerse in tepid water

-Lift and expel excess water by twisting


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3) application

- start at proximal part 1st

-roll bandage with strecting it

The setting of unmodified plaster starts about10 minutes after mixing and is complete in

about 45 minutes; however, the cast is not fullydry for 72 hours


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Complication

1)imparment of circulation

Fracture tissue edema increase pressure in cast circulation impairment

2) Plaster sore


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After care

Swelling ( normal # response vs circulatoryimpairment)

Discolouration of toes, fingers ( venous return)

Arterial obstruction .chek 5 P ( pain,paralysisat finger ,toes ,paraesthesia,perishing cold)

Can plaster be completed

Is the plaster intact Is plaster causing restriction

Is patient complaining localized pain..


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Thank you

cast immobilisation

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