Emillie Grace D.

Tombucon
 The branch of surgery concerned
with conditions involving
the musculoskeletal system.
Orthopedic surgeons use both
surgical and nonsurgical means to
treat musculoskeletal trauma, sports
injuries, degenerative diseases,
infections, tumors, and congenital
disorders.
 A cast holds a broken bone in place as it heals.
 Casts also help to prevent or decrease muscle
contractions, and are effective at providing
immobilization, especially after surgery.
 Casts immobilize the joint above and the joint
below the area that is to be kept straight and
without motion.
 For example, a child with a forearm fracture
will have a long arm cast to immobilize the
wrist and elbow joints.
 The outside, or hard part of the cast, is made
from two different kinds of casting materials.
 plaster - white in color.
 fiberglass - comes in a variety of colors,
patterns, and designs.
 Cotton and other synthetic materials are used to
line the inside of the cast to make it soft and to
provide padding around bony areas, such as the
wrist or elbow.
 Special waterproof cast liners may be used under
a fiberglass cast, allowing the child to get the
cast wet. Consult your child's physician for
special cast care instructions for this type of cast.
Type of Cast
1. Short arm cast:
 Applied below the elbow to the hand.
 Forearm or wrist fractures. Also used to hold the
forearm or wrist muscles and tendons in place
after surgery.
2. Long arm cast:
 Applied from the upper arm to the hand.
 Upper arm, elbow, or forearm fractures. Also used
to hold the arm or elbow muscles and tendons in
place after surgery.
3. Arm cylinder cast:
 Applied from the upper arm to the wrist.
 To hold the elbow muscles and tendons in place
after a dislocation or surgery.
4. Shoulder spica cast:
 Applied around the trunk of the body to the shoulder,
arm, and hand.
 Shoulder dislocations or after surgery on the shoulder
area.
5. Minerva cast:
 Applied around the neck and trunk of the body.
 After surgery on the neck or upper back area.
6. Short leg cast:
 Applied to the area below the knee to the foot.
 Lower leg fractures, severe ankle sprains/strains, or
fractures. Also used to hold the leg or foot muscles and
tendons in place after surgery to allow healing.
7. Leg cylinder cast:
 Applied from the upper thigh to the ankle.
 Knee, or lower leg fractures, knee dislocations, or after
surgery on the leg or knee area.
7. Unilateral hip spica cast:
 Applied from the chest to the foot on one leg.
 Thigh fractures. Also used to hold the hip or thigh muscles and
tendons in place after surgery to allow healing.
8. One and one-half hip spica cast:
 Applied from the chest to the foot on one leg to the knee of the
other leg. A bar is placed between both legs to keep the hips
and legs immobilized.
 Thigh fracture. Also used to hold the hip or thigh muscles and
tendons in place after surgery to allow healing.
9. Bilateral long leg hip spica cast:
 Applied from the chest to the feet. A bar is placed between both
legs to keep the hips and legs immobilized.
 Pelvis, hip, or thigh fractures. Also used to hold the hip or thigh
muscles and tendons in place after surgery to allow healing.
Short leg hip spica cast:
 Applied from the chest to the thighs
or knees.
 To hold the hip muscles and tendons
in place after surgery to allow
healing.
Abduction boot cast:
 Applied from the upper thighs to the
feet. A bar is placed between both legs
to keep the hips and legs immobilized.
 To hold the hip muscles and tendons in
place after surgery to allow healing.
 crutches
 walkers
 wagons
 wheelchairs
 reclining wheelchairs
 Keep the cast clean and dry.
 Check for cracks or breaks in the cast.
 Rough edges can be padded to protect the skin from
scratches.
 Do not scratch the skin under the cast by inserting
objects inside the cast.
 Can use a hairdryer placed on a cool setting to blow air
under the cast and cool down the hot, itchy skin. Never
blow warm or hot air into the cast.
 Do not put powders or lotion inside the cast.
 Cover the cast while your child is eating to prevent
food spills and crumbs from entering the cast.
 Prevent small toys or objects from being put inside the cast.
 Elevate the cast above the level of the heart to decrease swelling.
 Encourage your child to move his/her fingers or toes to promote circulation.
 Do not use the abduction bar on the cast to lift or carry the child.
 Older children with body casts may need to use a bedpan or urinal in order to go to the
bathroom. Tips to keep body casts clean and dry and prevent skin irritation around the
genital area include the following:
 Use a diaper or sanitary napkin around the genital area to prevent leakage or splashing
of urine.
 Place toilet paper inside the bedpan to prevent urine from splashing onto the cast or bed.
 Keep the genital area as clean and dry as possible to prevent skin irritation.
Contact your child's physician or healthcare
provider if your child develops one or more
of the following symptoms:
 fever greater than 101° F
 increased pain
 increased swelling above or below the cast
 complaints of numbness or tingling
 drainage or foul odor from the cast
 cool or cold fingers or toes
  refersto the set of mechanisms for
straightening broken bones or
relieving pressure on the spine
and skeletal system. There are two
types of traction: skin traction and
skeletal traction.
 Itis largely replaced now by more modern
techniques, but certain approaches are still
used today:
 Bryant's traction
 Buck's traction - hip fractures
 Dunlop's traction - humeral fractures in
children
 Russell's traction
 Milwaukee brace
 The purpose of traction is to:
 To regain normal length and alignment of
involved bone.
 To reduce and immobilize a fractured bone.
 To lessen or eliminate muscle spasms.
 To relieve pressure on nerves, especially
spinal.
 To prevent or reduce skeletal deformities or
muscle contractures.
 In most cases traction is only one part of the treatment plan
of a patient needing such therapy. The physician’s order will
contain:
 Type of traction
 Amount of weight to be applied
 Frequency of neurovascular checks if more frequent than
every four (4) hours.
 Site care of inserted pins, wires, or tongs
 The site and care of straps, harnesses and halters
 The inclusion of any other physical restraints / straps or
appliances (eg. mouth guard)
 the discontinuation of traction
 anorthopedic mechanism that helps
immobilize the upper arm in the
treatment of contracture or
supracondylar fracture of the elbow.
The mechanism uses a system of
traction weights, pulleys, and ropes
and may be accompanied by skin
traction. Dunlop skeletal traction is
usually applied unilaterally but may
also be applied bilaterally.
 anorthopedic mechanism consisting of
adhesive or nonadhesive skin traction that helps
immobilize the upper limb in the treatment of
contracture or supracondylar fracture of the
elbow. The mechanism uses a system of
traction weights, pulleys, and ropes, usually
applied unilaterally but sometimes bilaterally.
 Bryant'straction is mainly used in young
children who have fractures of
the femur or congenital abnormalities of the
hip. Both the patient's limbs are suspended in
the air vertically at a ninety degree angle from
the hips and knees slightly flexed. Over a period
of days, the legs hips are gradually moved
outward from the body using a pulley system.
The patient's body provides the countertraction.
 Orthopedics An apparatus for applying longitudinal
traction on the leg by contact between the skin and
adhesive tape, for maintaining the proper alignment of a
leg fracture; friction between the tape and skin permits
application of force through a cord over a pulley,
suspending a weight; elevation of the foot of the bed
allows the body to act as a counterweight; a type of
traction in which a nonconstricting boot with weights is
worn by the Pt to maintain proper alignment.
a unilateral or a bilateral orthopedic mechanism that
combines suspension and traction to immobilize,
position, and align the lower extremities in the
treatment of fractured femurs, hip and knee
contractures, and disease processes of the hip and
knee. Russell's traction is applied as adhesive or
nonadhesive skin traction and uses a sling to relieve the
weight of the lower extremities subjected to traction
pull. A jacket restraint is often incorporated to help
immobilize the patient.
 The Milwaukee brace, also known as a cervico-
thoraco-lumbo-sacral orthosis or CTLSO, is a back
brace used in the treatment of spinal curvatures
(such as scoliosis or kyphosis) in children. It is a full-
torso brace that extends from the pelvis to the base
of the skull. It was originally designed by Blount and
Schmidt in 1946 for postoperative care when surgery
required long periods of immobilization.
 Milwaukee braces are often custom-made over a mold of the
patient's torso, but in some cases, it can be made from
prefabricated parts. Three bars—two posterior and one
anterior—are attached to a pelvic girdle made of leather or
plastic, as well as a neck ring. The ring has an anterior throat
mold and two posterior occipital pads, which fit behind the
patient's head. Lateral pads are strapped to the bars;
adjustment of these straps holds the spine in alignment.
 This brace is normally used with growing adolescents
to hold a 25° to 40° advancing curve. The brace is
intended to minimize the progression to an
acceptable level, not to correct the curvature. For
corrective measures, special exercises or physical
activities are used. If the curvature continues despite
the brace, surgery may be required.
 The Milwaukee brace is often prescribed to be worn
23 hours a day for several years.
 Figure 1. Cervical halter skin traction. 

Figure 2. Pelvic belt traction. 

Figure 3. A pelvic sling is a traction device

consisting of a hammock-like belt wherein the
sling cradles the pelvis in its boundaries. It is used
for the treatment of one or more pelvic fractures.

Figure 4. Russell’s traction.

A bone fracture is a medical condition
in which there is a break in the
continuity of the bone. A bone fracture
can be the result of high forceimpact
or stress, or trivial injury as a result of
certain medical conditions that weaken
the bones, such as osteoporosis,
bone cancer, or osteogenesis
imperfecta, where the fracture is then
termed pathological fracture.
 Closed (simple) fractures are
those in which the skin is intact,
 Open (compound)
fractures involve wounds that
communicate with the fracture, or
where fracture hematoma is
exposed, and may thus expose bone
to contamination. Open injuries carry
a higher risk of infection.