CASTING

Types of CASTS
1. Plaster Casts ( POP) mold very smoothly to the body contour. 2. Non Plaster/ Synthetic Casts fiberglass casts that are commonly used today
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CASTS & MOLDS Short arm circular cast wrist and finger Short arm posterior mold- wrist and finger with compound affection Long arm circular castradius/ ulna Fuensters or munsters cast- radius/ ulna with callus formation. Long arm posterior moldfx of radius & ulna w/ compound affection
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CASTS & MOLDS Hanging cast shaft of humerus Functional arm cast humerus (allows abduction & adduction) Shoulder spica humerus and shoulder joint Airplane humerus and shoulder compound affection

CASTS & MOLDS

Rizzers jacket scoliosis Minerva upper dorsal cervical spine 1 & hip spica hip & femur Body cast lower dorsolumbar spine Double hip spica hip & femur Long leg cast- tibia, fibula Long leg posterior mold- fx of the tibia & fibula w/ compound affection Basket severe leg trauma w/ open wound or inflammation
Christian S. Tu, RN 5

CASTS & MOLDS

Cylindrical leg cast- patella Quadrilateral/ ischial weight bearing cast shaft of femur w/ CF Cast brace fx of the femur distal 3rd Short leg circular cast ankle & foot PTB- tibia/ fibula w/ CF Delbit cast- Tibia & fibula Short leg posterior mold ankle & foot w/ compound affection Boot leg cast for traction hip & femoral fx Internal rotator splint post hip operation

CASTS & MOLDS

Collar cast cervical affection Pantalon cast pelvic bone fracture Frog cast congenital hip dislocation Single hip spica hip & 1 femur 1 & spica mold hip & femur w/ compound affection Double hip spica- pelvic affection w/ CF +2 femur

CASTS & MOLDS

Single hip spica mold- pelvic bone fx w/ CF

Night splint post polio

immobilized a body part Exert uniform compression Provide for early mobilization Correct or prevent deformities Stabilize and support unstable joints

1. 2. 3. 4. 5.

Prepare the client Assist during application of casts PRN After cast application, provide cast care Initiate pain relief measures as indicated Observe for signs of cast syndrome especially with client who are immobilized in large cast.

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6. Provide nursing care for compartment syndrome, if indicated 7. Notify the physician immediately if signs of other neurovascular complications occur 8. Notify the physician if hot-spots occur 9. Provide client teaching 10. Ensure proper technique and procedure in cast removal.

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1. Support fresh cast with the palm of the hand to prevent indentations from tips of the fingers 2. Expose the cast to warm, circulating, dry air. Plaster cast - 5-15 minutes up to 48 hours

Synthetic cast 30 minutes

Dry cast : white, odorless, close to room temperature and resonant to percussion. Wet Cast: gray, cool, musty smelling and dull to percussion.
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Potential Pressure Areas/ Points

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 Check neurovascular status Alternate ambulation with periods of elevation to the cast when seated Perform active ROM hourly when awake by wiggling fingers/ toes. AVOID getting plaster cast wet, especially the padding under the cast DO NOT cover cast with plastic or rubber boots.
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Cast Care
NO weight bearing exercises for 24 hours after cast application Clean plaster cast using slightly damp cloth, by rubbing soiled areas with scouring powder and by wiping off residual moisture AVOID walking on wet floors or sidewalks to prevent falls DO NOT place objects under the cast to pressure and skin injury.
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1. Neurovascular problems (Compartment Syndrome) 2. Pressure Ulcers/ Sores severe initial pain over bony prominences, foul odor, purulent drainage & presence of hot spots 3. Immobility/ Disuse Syndrome results to multi-system problems
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Signs & Symptoms of COMPARTMENT SYNDROME

6 Ps
Pain aggravated by moving or elevating affected extremity; usually not relieved by analgesics Pallor Pulselessness Paresthesia occur early in the syndrome which progresses to. Paralysis late sign Puffiness late sign

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