22: Casts and Wraps - Frush Flashcards Preview

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Flashcards in 22: Casts and Wraps - Frush Deck (13)

cast vs. splint

- circumferential
- allows for greater stabilization
- does not allow for edema as much

- posterior with possible stirrup
- not as stable
- allow for edema
- good in acute trauma


why does plaster get hot when setting?

exothermic reaction due to gypsum


plaster v. fiberglass

- slower setting, heavy, hot when setting
+ excellent moldability, inexpensive

-/+ quick setting
- good moldability, more expensive
+ light weight, less exothermic reaction


how do you apply a splint?

1. stockinette to knee
2. cast padding from toes to knee (1 roll for foot, 1 roll for ankle)
3. dip fiberglass/plaster in water
4. apply posteriorly and/or medially and laterally
5. fold stockinee tover splint material ends
6. apply thin layer of cast padding (sometimes)
7. apply 4" ace to foot, 6" ace to leg


steps for fiberglass cast application

1. stockinette from past toes to knee
2. cast padding from toes to knees (1 foll foot and 1 roll leg to pad bony prominences)
3. apply 3" fiberglass roll to foot
4. apply 4" fiberglass roll to leg
5. fold down stockinette
6. apply 3" fiberglass roll from toes to knee (colored)


special rules for a weightbearing cast

- must be at 90 degrees
- accordion layer about half 3" fiberglass roll the length of foot and apply plantarly, secure with remainder of roll


good technique for cast saw

taking saw in and out of cast to allow blade to cool

poor - keeping saw uniformly in cast while removing


putting cast up too high can cause...

damage to common peroneal n.

should be 2-3 finger widths below

too short of a calf will cause too much movement and could lead to ulceration


risk factors for cast complication

- local anesthesia
- neuropathy
- difficulties with communication
- chronic edema
- improperly applied cast
- dipping water greater than 50 C


what might indicate an improperly applied cast

- too tight
- too loose
- goes past MPJ
- goes above tibial tuberosity
- wrinkles or indentations
- not enough padding


what is a jones compression wrap?

layered dressing for edema control

traditionally 3 layers, sometimes only 2 due to edema and bulk

one layer = 1 roll of cast padding from met heads to tibial tuberosity
- 4" ace on foot and 6" ace on leg


"soft cast"

unna boot
- zinc oxide impregnated gauze wrap
- apply ace, tape or coban over top
- applied from met heads to tibial tuberosity


indications for unna boot

- venous stasis ulcers
- edema control (sprains, acute injuries)
- more tolerable in hot climates than Jones Compression

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