Cast application

PLASTER OF PARIS

1. Close reductions and POP cast applications SUSHANT S SONARKAR

2. PLASTER OF PARIS SEMI HYDRATED CALCIUM SULPHATE CaSO 4 .½ H 2 O +1 ½ H 2 O = CaSO 4 .2H 2 Exothermic reaction

3. PLASTER OF PARIS COMMERCIAL POP ROLLS-ROLLS OF MUSLIN STIFFENED BY STARCH,POP POWDER & AN ACCELERATOR SUBSTANCE LIKE ALUM

4. POP- An Ideal Splint Cheap , easily available , comfortable Easy to mould , quick setting Strong & light Easy to remove Permeable to radiography Non -inflammable

5. PLASTER OF PARIS 4 forms- Slab Cast Spica Functional cast brace

6. SLAB Temporary splint USES Initial stages of fracture treatment & during first aid Immobilise the limb postoperatively & in infections It is made up of half by pop & half by bandage roll , hence can accommodate the swelling in the initial stages of fracture

7. CASTS Pop roll completely encircles the limb Definitive form of fracture treatment & corrects deformities 3 methods  Skin tight cast-cast is directly applied over the skin . can cause pressure sores. Difficult to remove as hair may be incorporated into the cast .

8.   Bologna cast-cotton padding is applied to the limb before putting the cast   Three tier cast- stockinette is used first over which cotton padding is done before applying the pop cast.

9. SPICA It encircles a part of the body Eg : hip spica , thumb spica

10. RULES OF APPLICATION OF POP CASTS

11. RULES OF APPLICATION OF POP CASTS Correct size- 8 in for thigh , 6 in for leg , 4 in for forearm Joint above & joint below should be included Should be moulded with palm & not with fingers for fear of indentation.

12. Joint should be immobilized in functional position. Plaster should be just fit & should not be too t ight or too loose. Uniform thickness of plaster is preferred.

13. Position of Immobilization Elbow : 90 degree of flexion Wrist : 30 degree of extension Thumb: midway between maximal radial and palmar abduction Hand : intrinsic plus (MCP joints in at least 70 degree of flexion and IP joints in extension)

14. Wrist: Moderate extension (10- 45degree) MCP joints: Flexion (70- 90 degree) PIP joints: Neutral

15. Lower limbs Hip : 10 - 30 degree of abduction 20 - 45 degree of flexion 15 degree of external rotation Knee: 15-30 degree of flexion Ankle: Neutral dorsiflexion

16. STAGES OF PLASTERING Application of pop slab Cast setting stage-change of pop to gypsum. T ime taken to form a rigid dressing after contact with water Set wet cast Cast drying by evaporation of excess water

17. COMPLICATIONS OF POP Due to tight fit  Pain  Pressure sore  Compartment syndrome Peripheral nerve injuries  Cast syndrome

18. COMPLICATIONS OF POP Due to improper application Joint stiffness Plaster blisters & sores Breakage Due to plaster allergy  Allergic dermatitis

19. Cast disease manifested as muscle atrophy , osteoporosis, joint stiffness , muscle weakness , skin breakdown , compartment syndrome , blister formation.