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