Ortho & Splinting
3/16/2017
Casting and Splinting: The Basics Brett Cascio
Splint vs Cast Safety – First Do No Harm Strength Comfort Dynamic You have to cut off a cast – Cast saws are loud and scary
Basics Padding padding padding Know your material – fiberglass gets hot and hard/ can be sharp Splinting/Casting is an ART – apply basic principles and adjust to individual situations
1
3/16/2017
Benefits of Immobilization Decrease Pain Helps with Swelling Decrease Bleeding Visual – covers up scary stuff Helps against messy – grocery bag analogy
From mild to severe injury
Not just for broken bones Used often to protect repairs Also used for soft tissue problems like diabetic wounds or burns Example: Total contact cast
2
3/16/2017
Risks of Immobilization Skin burns Pressure sores Stiffness
Common Splints Wrist/Hand Ankle/foot
Hand/Forearm Volar Ulnar gutter Sugar tong Thumb spica
3
3/16/2017
Buckle fracture
Volar Splint
Thumb Spica
4
3/16/2017
Sugar tong
Double Sugar Tong
5
3/16/2017
Supracondylar elbow fracture
Elbow Posterior splint
Shoulder/Clavicle Sling
6
3/16/2017
Fingers Buddy taping Padded aluminum splint In a child, growth plate fractures are common Beware “jammed” or “sprained” fingers Need x rays
Ankle/Foot Boot Posterior splint Add a stirrup? Is it overkill to put splint on leg for foot problem? - NO
Posterior short leg vs stirrup vs boot
7
3/16/2017
Leg/Knee Posterior splint Add side slabs for strength
Long leg splint vs knee immobilizer
Hip Spica Cast
8
3/16/2017
Thank you
9
Casting and Splinting: The Basics Brett Cascio
Splint vs Cast Safety – First Do No Harm Strength Comfort Dynamic You have to cut off a cast – Cast saws are loud and scary
Basics Padding padding padding Know your material – fiberglass gets hot and hard/ can be sharp Splinting/Casting is an ART – apply basic principles and adjust to individual situations
1
3/16/2017
Benefits of Immobilization Decrease Pain Helps with Swelling Decrease Bleeding Visual – covers up scary stuff Helps against messy – grocery bag analogy
From mild to severe injury
Not just for broken bones Used often to protect repairs Also used for soft tissue problems like diabetic wounds or burns Example: Total contact cast
2
3/16/2017
Risks of Immobilization Skin burns Pressure sores Stiffness
Common Splints Wrist/Hand Ankle/foot
Hand/Forearm Volar Ulnar gutter Sugar tong Thumb spica
3
3/16/2017
Buckle fracture
Volar Splint
Thumb Spica
4
3/16/2017
Sugar tong
Double Sugar Tong
5
3/16/2017
Supracondylar elbow fracture
Elbow Posterior splint
Shoulder/Clavicle Sling
6
3/16/2017
Fingers Buddy taping Padded aluminum splint In a child, growth plate fractures are common Beware “jammed” or “sprained” fingers Need x rays
Ankle/Foot Boot Posterior splint Add a stirrup? Is it overkill to put splint on leg for foot problem? - NO
Posterior short leg vs stirrup vs boot
7
3/16/2017
Leg/Knee Posterior splint Add side slabs for strength
Long leg splint vs knee immobilizer
Hip Spica Cast
8
3/16/2017
Thank you
9
