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    Cast and Traction

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    namme01_margate
    A cast immobilizes broken bones and joints to help them heal properly. The outside of a cast is typically made of plaster or fiberglass. Casts come in various types depending on the location of the injury, such as short arm casts, long leg casts, and hip spica casts. Casts must be kept clean, dry, and properly fitted to avoid complications and allow for healing.

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    Cast and Traction

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    namme01_margate
    276 views7 pages
    A cast immobilizes broken bones and joints to help them heal properly. The outside of a cast is typically made of plaster or fiberglass. Casts come in various types depending on the location of the injury, such as short arm casts, long leg casts, and hip spica casts. Casts must be kept clean, dry, and properly fitted to avoid complications and allow for healing.

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    A cast immobilizes broken bones and joints to help them heal properly. The outside of a cast is typically made of plaster or fiberglass. Casts come in various types depending on the location of the injury, such as short arm casts, long leg casts, and hip spica casts. Casts must be kept clean, dry, and properly fitted to avoid complications and allow for healing.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    276 views7 pages

    Cast and Traction

    Uploaded by

    namme01_margate
    A cast immobilizes broken bones and joints to help them heal properly. The outside of a cast is typically made of plaster or fiberglass. Casts come in various types depending on the location of the injury, such as short arm casts, long leg casts, and hip spica casts. Casts must be kept clean, dry, and properly fitted to avoid complications and allow for healing.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 7

    What is a cast?

    A cast holds a broken bone in place as it heals. Casts also help to prevent or decrease
    muscle contractions, and are effective at providing immobilization, especially after
    surgery.

    Casts immobilize the joint above and the joint below the area that is to be kept straight
    and without motion. For example, a child with a forearm fracture will have a long arm
    cast to immobilize the wrist and elbow joints.
    What are casts made of?
    The outside, or hard part of the cast, is made from two different kinds of casting
    materials.

    • plaster - white in color.


    • fiberglass - comes in a variety of colors, patterns, and designs.

    Cotton and other synthetic materials are used to line the inside of the cast to make it soft
    and to provide padding around bony areas, such as the wrist or elbow.

    Special waterproof cast liners may be used under a fiberglass cast, allowing the child to
    get the cast wet. Consult your child's physician for special cast care instructions for this
    type of cast.
    What are the different types of casts?
    Below is a description of the various types of casts, the location of the body they are
    applied, and their general function.

    Type of Location Uses


    Cast
    Short arm Applied below the Forearm or wrist fractures. Also used to hold the
    cast: elbow to the hand. forearm or wrist muscles and tendons in place after
    surgery.
    Long arm Applied from the Upper arm, elbow, or forearm fractures. Also used
    cast: upper arm to the to hold the arm or elbow muscles and tendons in
    hand. place after surgery.
    Arm Applied from the To hold the elbow muscles and tendons in place
    cylinder upper arm to the after a dislocation or surgery.
    cast: wrist.
    Illustrations of arm casts, 3 types

    Click Image to Enlarge


    Type of Location Uses
    Cast
    Shoulder Applied around the Shoulder dislocations or after surgery on the
    spica cast: trunk of the body to the shoulder area.
    shoulder, arm, and
    hand.
    Minerva Applied around the After surgery on the neck or upper back area.
    cast: neck and trunk of the
    body.
    Short leg Applied to the area Lower leg fractures, severe ankle sprains/strains,
    cast: below the knee to the or fractures. Also used to hold the leg or foot
    foot. muscles and tendons in place after surgery to
    allow healing.
    Leg Applied from the upper Knee, or lower leg fractures, knee dislocations, or
    cylinder thigh to the ankle. after surgery on the leg or knee area.
    cast:
    Illustrations of leg casts, 3 types

    Click Image to Enlarge

    Type of Cast Location Uses


    Unilateral hip Applied from the chest to the foot on Thigh fractures. Also used to
    spica cast: one leg. hold the hip or thigh muscles
    and tendons in place after
    surgery to allow healing.
    One and one- Applied from the chest to the foot on Thigh fracture. Also used to
    half hip spica one leg to the knee of the other leg. A hold the hip or thigh muscles
    cast: bar is placed between both legs to keep and tendons in place after
    the hips and legs immobilized. surgery to allow healing.
    Bilateral long Applied from the chest to the feet. A Pelvis, hip, or thigh fractures.
    leg hip spica bar is placed between both legs to keep Also used to hold the hip or
    cast: the hips and legs immobilized. thigh muscles and tendons in
    place after surgery to allow
    healing.
    Illustrations of hip spica casts, 3 types

    Click Image to Enlarge

    Type of Cast Location Uses


    Short leg hip Applied from the chest to To hold the hip muscles and tendons in
    spica cast: the thighs or knees. place after surgery to allow healing.
    Illustration of child wearing a short leg hip spica cast

    Click Image to Enlarge

    Type of Cast Location Uses


    Abduction boot cast: Applied from the upper To hold the hip muscles
    thighs to the feet. A bar and tendons in place after
    is placed between both surgery to allow healing.
    legs to keep the hips and
    legs immobilized.
    Illustration of child wearing abduction boots

    Click Image to Enlarge

    How can my child move around while in a cast?


    Assistive devices for children with casts include:

    • crutches
    • walkers
    • wagons
    • wheelchairs
    • reclining wheelchairs

    Cast care instructions:

    Cast care

    Keep your plaster cast dry at all times, or it will "melt." If it gets wet, it may soften or
    crack and lose its proper position. (If you have a fiberglass cast, keep it as clean and dry
    as possible.)

    • If your cast gets dirty, you can clean it with a damp (not wet) cloth. Then, keep
    the area uncovered until it's completely dry. To help dry the cast, you may use a
    hand-held dryer on a cool setting (never use the hot settings because it might
    burn you).
    • If your cast starts to smell bad, rub a little bit of dry baking soda into the soiled
    areas.
    • Check daily to be sure the cast is not too tight or too loose. If you feel tightness,
    pain, tingling, numbness, or you can't move your toes/fingers, or if there is
    swelling, elevate your leg/arm on a pillow for one hour. If you don't feel better,
    call your doctor. A cast that is too tight could cut off the blood supply or damage
    nerves.
    • The fingers/toes on the arm/leg with the cast should stay pink and feel warm, like
    on the fingers or toes on the other side. Call your doctor if your fingers/toes
    become swollen, cold, pale, or blue, or if you can't move them.
    • Never put anything into the cast or play with small objects like coins and toys that
    could fall down into the cast. Objects like coat hangers and pencils can break the
    skin and cause infection. If this happens and you can't remove the item with your
    fingers, call your doctor immediately.
    • Never stuff cotton or toilet tissue under the edges of the cast — it may decrease
    blood circulation.
    • Never trim or cut the length of the cast.
    • Follow your doctor's instructions about physical activity carefully. Don't let your
    child play in dirt or sand.

    Older children with body casts may need to use a bedpan or urinal in order to go to the
    bathroom. Tips to keep body casts clean and dry and prevent skin irritation around the
    genital area include the following:

    • Use a diaper or sanitary napkin around the genital area to prevent leakage or
    splashing of urine.

    • Place toilet paper inside the bedpan to prevent urine from splashing onto the cast
    or bed.

    • Keep the genital area as clean and dry as possible to prevent skin irritation.

    In orthopedic medicine, traction refers to the set of mechanisms for


    straightening broken bones or relieving pressure on the spine and skeletal
    system. There are two types of traction: skin traction and skeletal traction.

    It is largely replaced now by more modern techniques, but certain approaches


    are still used today:

     Bryant's traction
     Buck's traction - hip fractures
     Dunlop's traction - humeral fractures in children
     Russell's traction
     Milwaukee brace

    Skeletal traction

    Although the use of traction has decreased over the years, an increasing number
    of orthopaedic practitioners are using traction in conjunction with bracing
    (see Milwaukee brace). The section below provides some details on traction and
    its use.
    Bryant's Traction

    Bryant's traction is mainly used in young children who have fractures of


    the femur or congenital abnormalities of the hip.[1] Both the patient's limbs are
    suspended in the air vertically at a ninety degree angle from the hips and knees
    slightly flexed. Over a period of days, the hips are gradually moved outward from
    the body using a pulley system. The patient's body provides the countertraction.
    Purpose

    The purpose of traction is to:

     To regain normal length and alignment of involved bone.


     To reduce and immobilize a fractured bone.
     To lessen or eliminate muscle spasms.
     To relieve pressure on nerves, especially spinal.
     To prevent or reduce skeletal deformities or muscle contractures.

    In most cases traction is only one part of the treatment plan of a patient needing
    such therapy. The physician’s order will contain:

     Type of traction
     Amount of weight to be applied
     Frequency of neurovascular checks if more frequent than every four (4)
    hours.
     Site care of inserted pins, wires, or tongs
     The site and care of straps, harnesses and halters
     The inclusion of any other physical restraints / straps or appliances (eg.
    mouth guard)
     the discontinuation of traction

    Responsibility of initial application

    The physician is typically responsible for initial application of traction and weights
    while the adjustment or removal (to perform ablution functions / physiotherapy) of
    skeletal traction weights will be based on the doctors charted plan.
    In most cases cervical traction may be adjusted or temporarily removed, per
    physician order, by an orthopedic nurse who has documented competency to do
    so.

    The alignment and moving of the patient will only be changed on physician's
    directive and the affected extremity will need to be maintained in proper
    alignment at all times with the ropes and traction straps - making sure the
    mentioned is unobstructed and weights hanging freely.

    If it is necessary to move the patient while skeletal traction is in place, the patient
    should be moved in the bed with weights hanging freely.

    In most cases traction will be applied for a number of weeks to months and
    Neurovascular checks will need to be performed by a nurse as ordered by the
    physician or as dictated per traction unit policy.

    Traction is an appropriate treatment for a number of medical problems including


    spinal deformities such as scoliosis.

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