CAST

• cast is an immobilizing device made of layers of plaster of Paris or fiber glass, bandages molded to the body part
• Functions and Purposes of Cast

  ·       Prevent and correct deformity

  ·       Immobilized the affected part

  ·       Promote healing and early weight bearing

  ·       Apply uniform compression of soft tissue

  ·       Support and stabilized weak joints

  ·       To maintain, protect and realigned the bone
• Principles in Applying Plaster Cast

  ·       Check the doctor’s order

  ·       Inform and prepare the client for the procedure

  ·       Prepare the equipment

  ·       Position the extremity

  ·       Apply padding materials

  ·       Soak POP for minutes till bubbles formed

  ·       Apply in circular motion, turn is ½ the previous turn.

  ·       Start from distal to proximal

  ·       Maintain desired position throughout the cast application

  ·       Use caution in handling the cast until it become hardened
• ·       If the affected area is with Open wound, swelling, and infection- molds and splint only

  ·       If closed fracture, no infection and swelling-Cast should be applied
• SHORT ARM CIRCULAR CAST

  ·       Fractured forearm and wrist

  ·       Below the elbow of the hand
• LONG ARM Circular CAST

  Upper arm, elbow and forearm fractures
• ARM CYLINDER CAST

  o   To hold elbow muscles and tendons in place after surgery or dislocation

  o   Applied from the upper arm to the wrist
• HANGING CAST

  ·       Fractured on the shaft of the humerus

  ·       cast from the axilla to the wrist with the elbow held in flexion
• SHOULDER SPICA CAST

  ·       Fx humerus and shoulder joint dislocation/ after surgery on the shoulder area
• Fuenster/Muenster

  ·       Fractured radius and ulna with callus formation
• Airplane Cast

  ·       Humerus and shoulder joint with compound affection

  ·       For recurrent shoulder dislocation
• Functional Cast

  ·       Fracture of upper humerus with callus formation
• Short Leg Circular Cast

  ·       Fx of ankle and foot
• ·       Long Leg Circular Cast

  Fx tibia and fibula
• ·       CYLINDER LEG CAST

  For Fx patella with compound affection
• Patellar Tendon Bearing Cast

  o   Fx distal Tibia and fibula with callus formation
• Quadrilateral/ Ischial Weight Bearing Cast

  o   Fractured shaft of the femur with callus formation
• DELVITT Cast

  o   Fx of tibia and fibula which allows ankle and foot movement
• Walking Cast

  o   Fracture of ankle and foot with callus formation
•  Basket Cast

  o   Severe leg trauma with open wound or inflammation

   
• Cast Brace

  o   Fracture of femur which allows extension and flexion
• COLLAR CAST

  Fracture of cervical spine and supports chin and neck

   
• BODY CAST

  cast enclosing the trunk of the body

  Lower dorso-lumbar spine affection
• Minerva Cast

  Upper dorsal cervical spine

  Mild scoliosis
• RIZZER’s Jacket

  Severe Scoliosis/ thoracolumbar spine affection
• PANTALON CAST

  Pelvic bone fracture
• FROG CAST

  Congenital hip dislocation
• Plaster of Paris

  Advantage

  o   Readily applied

  o   Cheaper

  o   Readily available

  o   Strong
• Plaster of Paris Disadvantage

  o   Heavy

  o   Warm

  o   Pressure problems

  o   Difficult to inspect limbs

  o   Not water proof
• • WINDOWING is the removal of a part of the cast
• BIVALVING  Involves splitting of the cast
• • FASCIOTOMY long incisions through the skin and the fascia layer underneath to decrease pressure and restore blood flow

   
• Complications of Cast

  o   Compartment Syndrome

  o   Thermal injuries

  o   Pressure sores

  o   Skin infection and dermatitis

  o   Joint stiffness

   
• o   Hallmark Signs of compartment syndrome Pain, Pallor, Paresthesia, Pulselessness and Paralysis
• Care of Patient on Cast

  o   Handle wet cast with PALMS NOT FINGERS
• o   Cast extremities are elevated using pillows

  o   Cast must remain OPEN to the air until dry

  o   Cast should not be covered with blanket or towel while drying

  o   Observe “Hot spot” and “musty odor”

  o   Maintain skin integrity by petalling

  o   Do not use baby powder near the cast

  o   Do neurovascular checks

  o   Never walk on a cast until it is completely dry.