Casting, Splinting, Taping Lab

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Casting, Splinting, Taping Lab

• Edward Via Virginia College of Osteopathic
  Medicine
• Block 9
• Dr. Linda Frasca

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Casts used to Treat

• A variety of stable, acute fractures
• Reduced dislocations
• Injuries to the soft tissues
• Congenital and acquired deformities
• Stabilize and protect postoperative repairs

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Splinting Benefits

• Stability for soft tissue injuries
• Pain relief
• Easily removable for icing, etc.
• Provides temporary support for patients
  needing surgery

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Taping

• Temporary measure
• Restrict motion of joint that is taped
• Compress soft tissue to prevent swelling
• Support the involved anatomy
• Secure dressing or bandage
• Secure a splint already in place

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Cast application Equipment

• Stockinette (2, 3 ,4 inch widths)
• Cast padding
• Cast material plaster or fiberglass
• Water source, gloves
• Cast saw, spreader and scissors
• Assistant (preferably a VCOM student as I hear
  they are the best!)

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Splinting Equipment

• Premade splint material (plaster or synthetic) or
  plaster cast material
• Gloves
• Water source
• Scissors
• Compression wrap (ace bandage)
• Assistant (preferably a VCOM student)

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Taping Equipment

• Skin prep (benzoin)
• Underwrap
• Athletic Tape
• Pressure pads or moleskin
• Of course an assistant (you guessed it,
• a VCOM student, yes the best)

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Casting Pearls from Dr. Gunnar Brolinson

• First, do no harm, be gentle
• Immobilize in position of function
• Skin clean and dry
• Do not immobilize unnecessarily
• Plenty of stockinette

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Continue casting pearls

• Pad bony prominences
• Apply casting tape with roll-up
• in candy cane fashion
• Remember curing time
• Mold appropriately
• Take home instructions

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Contraindications

• Early (premature casting) Casting before maximal
  swelling has occurred can cause necrosis and
  possibly compartment syndrome
• Open wound never place a cast over an open wound
  as potential for infection
• Unstable fractures need surgical repair

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Complications

• Compartment syndrome pain out of proportion to
  the injury, paresthesias.
• Pulselessness and pallor are not part of
• the syndrome.
• Initial treatment is to bivalve cast or
• remove, may require surgery
• Skin conditions
• Nerve palsy
• Joint stiffness

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The Joke
A tightfisted businessman broke his hip. He
hired the most esteemed surgeon in town to put
him back together, which required lining up the
broken hip and putting in a screw to secure
it. The operation was successful, and the
surgeon charged the businessman a fee of 5000
for his services. The businessman was outraged
by the amount charged and sent the surgeon a
letter demanding an itemized bill. The
doctor complied, sending back the list
One screw 1 Knowing how to put it
in 4999 Total 5000