Splints, Braces and Casts Flashcards
Splints vs Brace
-Splints are STIFF
=Immobilise motion
=Often used immediately following trauma
-Braces BEND
=Control motion
=More commonly used during rehabilitation
Both are removable
Describe casts
-A type of splint, but more rigidly immobilise a region
-Cannot be removed by the patient
-Three key principles when casting an injury:
1. Full cast or a partial cast ?
2. Which region(s) to cast ?
3. What material to use?
Casts vs Splints
Cast
-Acute management of fractures
-Doesn’t permit swelling
-Needs sawing/ peeling off
-Higher complication rate
-Rigid immobilisation
Splint
-Acute management of some fractures
-Allows swelling
-Easily removable
-Lower complication rate
-Less rigid
Full cast vs Back Slab
-Injuries swell following trauma; this regresses by ~14 days
-Therefore, you generally should not place an injury into a full cast for the first 10-14 days, to allow it swell.
-Material:
=Backslabs are typically made from Plaster of Paris
=Full casts are typically made of fibreglass (i.e., plastic)
What should be immobilised in a cast?
If fracture
-Near the joint (i.e., metaphysis or epiphysis) -> immobilise that joint only
-In the diaphysis -> immobilise the joint above and below, as this will control rotation
Complications of splints, braces, casts
-Pain
-Neurovascular deficit
-Pressure sores
Pain and management
-Normal pain, swelling (a tight cast), compartments syndrome
-Conservative: Elevate
-Medical: Analgesia
-Surgical: Split the cast
Management of neurovascular deficit
-Due to injury?: check A&E and admission clerking
-Due to immobilisation or positioning: evolved since the cast/ splint was applied
-Due to surgery: check anaesthetic chart- regional block?
-Due to complication: any features of compartment syndrome
Management of pressure sores
Never tightly apply a dressing to any bony prominences: pad these areas well (with wool)
