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