Bandages And Splints

Question 1

Functions of a bandage

Answer 1

Protection
Absorption of draining material
Compression of soft tissues
Stabilization/external coaptation

Question 2

External coaptation

Answer 2

Splint or cast used as primary stabilization technique for fracture management or support surgical repair, joint instability

Forms: temporary, primary, secondary

Question 3

Indications for external coaptation as primary fracture repair

Answer 3

Incomplete fracture in young animal
Simple fracture with minimal displacement
Ulna or fibula intact
Can stabilize joint above + below fracture
Financial constraint of owner

Below knee or above elbow

Question 4

Contraindications for external coaptation as primary fracture management

Answer 4

Joint fractures
Inability of split to counteract fracture forces
Joint cannot be stabilized above/below fracture

Question 5

Process for closed fracture reduction

Answer 5

Radiographs
Sedation/anesthesia
Limb alignment/fragment apposition
Appropriate bandage/split
Assess reduction by radiograph

Question 6

Requirements for radiographs of fracture

Answer 6

2 orthogonal views
Visualize joint above and below fracture

Question 7

Purpose of sedation/anesthesia

Answer 7

Reduce pain

Keep patient still while splinting

Muscle relaxation to assist manipulation

Question 8

Alignment

Answer 8

Orientation of bone with respect to normal anatomic axis (in all planes)

position of joint above/below fracture

Question 9

Reduction

Answer 9

Act of placing fracture fragments into apposition

Question 10

Apposition

Answer 10

Assessment of how fracture fragments relate to one another (how well fit together)

Question 11

Fracture reduction + alignment

Answer 11

Distract and manipulate fracture ends (90 deg hinge, then slowly straighten to fatigue muscles - working against muscle contraction)

Interdigitate ends

Goal: 100% apposition; 50% in 2 views is acceptable

Contraindications: bone starts to splinter or break

Question 12

Factors for selecting bandage material

Answer 12

Extent of soft tissue damage
Wounds
Type of weight bearing / joint mobility needed
Available materials
Size of patient
Temperament

Question 13

Bandage layer

Answer 13

Contact (primary) layer
Intermediate (secondary) layer - absorb fluid, support, compression
Outer (tertiary) layer - protect from environment, hold in place

Question 14

Tape stirrups

Answer 14

Used to prevent bandage from slipping off

Stick side of tape on dry limb
- medial/lateral or dorsal palmar
- extend 25-50% of bandage
- extra at end to turn up

Not always needed

Question 15

Application of cast padding / cotton

Answer 15

Start distally —> move up
Start with 100% overlap at toes
Overlap each layer by 50% up limb
Not too tight - will tear

Question 16

Kling gauze layer of bandage

Answer 16

Start distally —> move up

Snug, but not too tight

Always placed over appropriate amount of cotton

Holds splint

Question 17

Outer vet wrap/tape

Answer 17

Not directly on hair or skin
Should not be needed to keep bandage from slipping
Loosely placed

Question 18

Robert-Jones Bandage

Answer 18

Bulky compression bandage
Temporary support
Decrease swelling

Question 19

Modified Robert-Jones bandage

Answer 19

Less cast padding, but enough to suppor / prevent rubbing of splint material

Compression bandage

Question 20

Masson metal or plastic splints

Answer 20

Use with modified Robert Jones

Indications: digit, metacarpal, metatarsal injuries

“Spoon” under foot —> partial weight bearing

Question 21

Aluminum rod splits

Answer 21

Use with modified Robert Jones
Form aluminum rod to shape of leg
Lateral splint or walking bar (weight bearing rod)
Varied thickness

Question 22

Orthoplast splits

Answer 22

Plastic-y material; shaped when placed in hot water

Strong
Can cut to size
More expensive than fiberglass
Can be reshaped

Use with modified Robert Jones

Question 23

Full cast

Answer 23

Rarely used in vet med

Question 24

Cast materials

Answer 24

Fiber glass : light weight, strong, can be used to make splints

Question 25

Cast application

Answer 25

Sedation/anesthesia
Stirrups
Primary layer (sometimes stockinet)
Cast padding
Kling gauze
Turn stirrups up
Apply cast (wet material, squeeze out excess water, 50% overlap)

Question 26

Layers of cast material

Answer 26

Small dogs - at least 2
Large dogs - at least 4-6

Question 27

Bivalve cast modification

Answer 27

Full cast cut in half

Allows for swelling/changes to visualize skin/wounds

Not as strong

Question 28

Half cast/split

Answer 28

Use of cast material as a splinting device

Most common use of cast material

Question 29

Spica split

Answer 29

Splint to immobilize shoulder / hip joint

Modified Robert Jones encircling torso under split

Split: aluminum rod, orthoplst, casting material

Question 30

Schroeder-Thomas splint

Answer 30

Not really used, difficult to keep from moving

Traction splint for minimally displaced fracture

Question 31

Velpeau sling

Answer 31

Maintains carpus, elbow, shoulder in flexion

Non-weight bearing

Indications: shoulder luxation / fracture

Question 32

Elmer sling

Answer 32

Used for craniodorsal hip luxation
Non-weight bearing
Internally rotates hip + abducts limb

1-2 wk

Question 33

Carpal flexion bandage

Answer 33

Used after flexor tendon repair

Relieves tension from flexor tendons, non-weight bearing

Caution: don’t leave too long or permanent contracture

Question 34

Hobbles

Answer 34

Used for caudal ventral hip luxation
Prevents abduction
Weight bearing

Question 35

Complications associated with bandaging

Answer 35

Pyderma, deep infections
Skin abrasions
Loss of bone density
Loss of ROM
Muscle contracture
Ligament laxity
Loss of cartilage

Question 36

At home instructions

Answer 36

Monitor toes
Monitor for slipping
Pain
Avoid becoming wet/soiled

Recheck weekly

E-collar!!!