Plaster immobilization is done after reduction of the fracture segments. This can be completed immediately but incomplete plaster by application of only plaster slab is done where swelling of the limb is expected.
Subsidence of swelling takes place after a period of 48 hours when complete plaster is done. In Modern science surgeon are using implants to join fracture bone. Siora Surgicals Pvt Ltd is one of top Orthopedic Equipment Manufacturers company in India for importing and exporting Surgicals instrument.
PLASTER FOR UPPER LIMB
SHORT ARM PLASTER
Indications: Short arm plaster is applied in fractures of carpal, metacarpal bones, Colles’ fracture, fracture involving the styloid process of radius and dislocation round the wrist joints. The plaster should reach proximal to the head of metacarpal bones over the dorsal surface of the hand. Movements of the thumb should always be encouraged. Immobilization of thumb is only necessary in fracture of the first metacarpal and fracture of the scaphoid bone.
SPECIAL TYPES OF SHORT ARM PLASTER
Colles’ Fracture: Usually an incomplete plaster is applied as a dorsal slab before completion of the plaster. This is usually completed after 48 hours. The slab should mould round the lateral aspect of the forearm which is maintained in a pronated position; wrist- joint is kept flexed at 10p and in stability ulnar deviated position.
Scaphoid Plaster: Usually no padding is done and a skin- tight plaster is applied. This is mostly completed on the very first occasion. The purpose of immediate completion of plaster is to maintain the apposition of the fractured scaphoid segments from the beginning. The wrist- joint should be in a position of little dorsiflexion and lateral deviation. The thumb should be placed in apposition with the tip of the index finger while application of the plaster is done. The plaster must immobilize the metacarpophalangeal joint of the thumb.
Interphalangeal joint is spared from the plaster.
LONG ARM PLASTER
Indications: Long arm plaster is applied in fractures of the radius and ulna, fracture involving the bones round the elbow- joint, and undisplaced fracture of the olecranon process.
Technique: The purpose of long arm plaster is to immobilize both the wrist and elbow- joints. The shoulder and finger- joints are left mobile.
Extension of Slab: the dorsal slab extends from about 2” below the axilla to the knuckle.
Position of forearm: In most cases the elbow should be kept at 90p flexion. In fracture of radius and ulna the forearm should be kept in a characteristic position depending upon the site of lesion; this maintains the fractured fragments the fractured fragments in apposition. Shoulder and finger movements must remain free. Evidence of any neurovascular complication must always be looked for. The arm should be rested in a cuff and collar sling.
PLASTER FOR LOWER LIMB
In most cases either short or long leg plasters are used in the lower limbs.
SHORT LEG PLASTER OR BELOW KNEE PLASTER
Indication: Below knee plasters are applied in fractures of the tarsal, metatarsal bones, fractures round the ankle- joints, calcaneum and malleolar fractures. This is also done in distal locations of the ankle, tarsal and metatarsal joints.
Technique: Where chance of swelling of the limb exists, it is customary to use only the dorsal slab initially. The completion of plaster is done after the subsidence of swelling. Bony prominences are protected and the leg is first padded by cotton wool or stockinette.
Position of the Patient: Plaster can be done with the patient’s legs hanging from the edge of the table or while the assistant holds the affected leg up with both hands. Proper padding near the head of fibula and both malleoli is essential. For Orthopedic implants importer and dealer ship, kindly fell free to contact us.
Extension of Plaster: The plaster should extend proximally up to tibial tubercle while the distal end must support the metatarsal heads of the feet. In some cases the plantar aspect of the plaster should extend beyond the toes to provide to the toes.
Position of Ankle- Joint: The ankle- joint should be retained in a neutral position and without any inversion. Failure to do this will produce equinus deformity of the ankle- joint.
Short Leg Plaster with Equinus Position of Ankle: Plaster in equinus position of the ankle is done in cases of avulsion fracture of the calcaneum and following rupture of the Achilles tendon.
Weight Bearing Plaster: Various procedures have been advocated where weight bearing is allowed. Undermentioned techniques are commonly used for this purpose.
Walking iron: Walking iron can be fixed to the plaster cast by means of plaster bandage. This technique adds further weight to the plastered limb which is a disadvantage.
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