Cast Types and Maintenance Instructions
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 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 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 plaster - wh white ite in col color. or. fiberglass - come comes s in a variety variety of colors colors,, patterns, patterns, and 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 allowing the child to get the cast wet. Consult your child's physician for special cast c ast care instructions for this type of cast.
FUNCTIONS
To
promote healing and early weight bearing
To
To
prevent or correct deformity
To
immobilize
support, maintain and protect realigned bone
CONTR AINDICATIONS Pregnancy Skin disease Swelling / Edema
Open
wound
Infection
NURSING CARE Handle wet cast with palms of hands, not fingers Cast should be allowed to air dry Elevate cast on one to two pillows during drying
Observe
³hot spot´ and musty odor. These are signs and symptoms of infection.
Maintain skin integrity
Do neurovascular checks: ± Skin color ± Skin temperature ± Sensation ± Mobility ± Pulse
Assess for vascular occlusions Adhesive tape petals reduce irritation and cast edges
Prevent complications of immobility ± Bedsores ± Hypostatic pneumonia ± Constipation ± Renal calculi ± Osteoporosis ± Muscular atrophy
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 Cast Short arm cast:
Location Applied below the elbow to the hand.
Long arm Applied from cast: the upper arm to the hand. Arm Applied from cylinder the upper cast: arm to the wrist.
Uses Forearm or wrist fractures. Also used to hold the forearm or wrist muscles and tendons in place after surgery. Upper arm, elbow, or forearm fractures. Also used to hold the arm or elbow muscles and tendons in place after surgery. To
hold the elbow muscles and tendons in place after a dislocation or surgery.
Type of Cast
Location
Shoulder Applied around the trunk spica of the body to the cast: shoulder, arm, and hand.
Uses
Shoulder dislocations or after surgery on the shoulder area.
Minerva cast:
Applied around the neck After surgery on the neck or upper and trunk of the body. back area.
Short leg cast:
Applied to the area below the knee to the foot.
Lower leg fractures, severe ankle sprains/strains, or fractures. Also used to hold the leg or foot muscles and tendons in place after surgery to allow healing.
Leg cylinder cast:
Applied from the upper thigh to the ankle.
Knee, or lower leg fractures, knee dislocations, or after surgery on the leg or knee area.
Type of Cast
Location
Unilateral hip spica cast:
Applied from the chest to the foot on one leg.
One and onehalf hip spica cast:
Applied from the chest to the foot on one leg to the knee of the other leg. A bar is placed between both legs to keep the hips and legs immobilized.
Bilateral long leg hip spica cast:
Applied from the chest to the feet. A bar is placed between both legs to keep the hips and legs immobilized.
Uses Thigh
fractures. Also used to hold the hip or thigh muscles and tendons in place after surgery to allow healing.
Thigh
fracture. Also used to hold the hip or thigh muscles and tendons in place after surgery to allow healing. Pelvis, hip, or thigh fractures. Also used to hold the hip or thigh muscles and tendons in place after surgery to allow healing.
Type of Cast
Location
Short leg hip spica cast:
Applied from the chest to the thighs or knees.
Uses
To
hold the hip muscles and tendons in place after surgery to allow healing.
Type of Cast
Location
Abduction boot Applied from the cast: upper thighs to the feet. A bar is placed between both legs to keep the hips and legs immobilized.
Uses To
hold the hip muscles and tendons in place after surgery to allow healing.
How
can my child move around w hile in a cast?
Assistive devices for children with casts include: crutches walkers wagons wheelchairs reclining wheelchairs
Cast care instructions: y y y
y
y
Keep the cast clean and dry. Check for cracks or breaks in the cast. Rough edges can be padded to protect the skin from scratches. Do not scratch the skin under the cast by inserting objects inside the cast. Can use a hairdryer placed on a cool setting to blow air under the cast and cool down the hot, itchy skin. Never blow warm or hot air into the cast.
Do not put powders or lotion inside the cast. Cover the cast while your child is eating to prevent food spills and crumbs from entering the cast. Prevent small toys or objects from being put inside the cast. Elevate the cast above the level of the heart to decrease swelling. Encourage your child to move his/her fingers or toes to promote circulation. Do not use the abduction bar on the cast to lift or carry the child. y
y
y
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.
When
to call your child's physician:
fever greater than 101° F increased pain increased swelling above or below the cast complaints of numbness or tingling drainage or foul odor from the cast cool or cold fingers or toes
TR ACTION Is the act of pulling or drawing which is associated with counter traction. Traction means that a pulling force is applied to a part of the body or an extremity while a counter traction pulls in the opposite direction. In straight or running traction coutertraction is supplied by the patient¶s body with the bed.
PURPOSES Prevent / correct deformity
Relieve
pain
Relieve
muscle spasm
Reduce
/ immobilize fractures
PRINCIPLES Principles should be supine Avoid friction Allow the weights to hang freely Apply traction continuously
There
should be an adequate countertraction
The
line of pull should be in line with the deformity
TYPES Skin traction Skeletal traction Manual traction
NURSING CARE Skin ± Monitor for vascular occlusion ± Maintain countertraction ± Maintain weights hanging freely ± Maintain positioning ± Provide daily rewrapping ± Detection of pressure points
Skeletal ± Inspection ± Dressing ± Traction apparatus (maintain alignment) ± Skin care ± Prevent complications of bed rest
Muscles ± Strengthening exercise for upper extremities ± Strengthening exercise for lower extremities ± Preparation for crutch walking
