Casting and Splinting

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Casting and Splinting

• Ravjot Sarao, M.D.
• UAB-Selma Family Medicine

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Background

• To immobilize orthopedic injuries
• To promote healing
• Maintain bone alignment
• Diminish pain
• Protect injury
• Help compensate for surrounding muscular weakness

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Conditions that benefit from Immobilization
American Family Physician Vol 79, number 1
January 1 2009
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Splinting Vs Casting

• Assess the stage and severity of injury
• Potential for instability
• Risk of complications
• Patients functional requirements
• Splints for 1. simple and stable fractures, 2.
  sprains, 3. tendon injuries, 4. other soft tissue
  injuries
• Casting for definitive and/or complex fracture
  management

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Splinting custom made or off-the-shelf

• ADVANTAGE
• Faster and easier
• Static or dynamic
• Pressure related complications are less like skin
  breakdown, necrosis, compartment syndrome
• Easy removal

• DISADVANTAGE
• Lack of patient compliance and excessive motion
  at injury site
• Not for unstable or potentially unstable
  fractures like segmental or spiral or dislocated
  fractures

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Casting

• ADVANTAGES
• Mainstay of Tx for most fractures
• More effective immobilization

• DISADVANTAGES
• Require more skills
• More time to apply
• Higher risk of complications

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Complications
American Family Physician Vol 79, number 1
January 1 2009
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Materials and Equipment
American Family Physician Vol 79, number 1
January 1 2009
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Procedure Video
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Patient instructions

• Elevate the limb
• Check circulation
• Watch for increased swelling
• Check mobility distally
• Protect skin from rough edges
• Keep cast dry
• Do not remove the cast
• Do not put anything inside the cast

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Return to ER or a physician if

• Pain
• Skin color changes
• Sensation changes
• Inability to move fingers
• Bad odor or staining
• Too tight or too loose
• Foreign objects in cast