Prof. Md Shahiduzzaman Head, Department of Orthopaedics and Traumatology Dhaka Medical college Hospital
<ul><li>Recognise the fracture….always </li></ul><ul><li>Reduce the fracture…..If possible </li></ul><ul><li>Maintain redu...
<ul><li>Clinical </li></ul><ul><ul><li>LOOK, ASK, FEEL. </li></ul></ul><ul><ul><li>Look for nerve damage. </li></ul></ul><...
<ul><li>X-ray: (Rongentogram) </li></ul><ul><ul><li>At least two views </li></ul></ul><ul><ul><li>See joints above and bel...
<ul><li>Not all fractures need reduction </li></ul><ul><li>Fracture needs Reduction </li></ul><ul><ul><li>Fracture involvi...
 
<ul><li>BANDAGE </li></ul><ul><li>BACK SLAB </li></ul><ul><li>TRACTION </li></ul><ul><li>EXTERNAL FIXATION </li></ul><ul><...
<ul><li>It begins soon after injury. </li></ul><ul><li>Speak to the patient gently, tenderly and confidently. </li></ul><u...
<ul><li>Plaster of Paris is prepared from Gypsum, which is a crystalline form of calcium sulphate, by heating to 130°C. Th...
Plaster of Paris Powder Commercial Pack
<ul><li>Immobilization of fractures </li></ul><ul><li>Post-operative fixation </li></ul><ul><li>To prevent or correct defo...
<ul><li>Advantages: </li></ul><ul><ul><li>It can be used individualized. </li></ul></ul><ul><ul><li>It is durable , if tak...
Cast is Translucent  under X-ray Plaster Sore
<ul><li>Contact Doctor immediately  if you feel.. </li></ul><ul><ul><li>The toes or fingers become blue or swollen. </li><...
<ul><li>Exercise the joints not under the cast. </li></ul><ul><li>Do not let the limb hang down especially first few days....
Plaster for the upper limb <ul><li>From </li></ul><ul><li>½ “ proximal to MP Joints </li></ul><ul><li>To </li></ul><ul><li...
Plaster for the upper limb <ul><li>From </li></ul><ul><li>½ “ proximal to MP Joints and distal Palmar crease. </li></ul><u...
Upcoming SlideShare
Loading in...5
×

conservative management of simple fractures

4,250

Published on

Dr. Abdullah-Al-Mamun
Resident, Department of Orthopaedics and Traumatology
Dhaka Medical College
01716135120

Published in: Health & Medicine, Business

conservative management of simple fractures

  1. 1. Prof. Md Shahiduzzaman Head, Department of Orthopaedics and Traumatology Dhaka Medical college Hospital
  2. 2. <ul><li>Recognise the fracture….always </li></ul><ul><li>Reduce the fracture…..If possible </li></ul><ul><li>Maintain reduction…..always </li></ul><ul><li>Reahabilitation….always </li></ul>
  3. 3. <ul><li>Clinical </li></ul><ul><ul><li>LOOK, ASK, FEEL. </li></ul></ul><ul><ul><li>Look for nerve damage. </li></ul></ul><ul><ul><li>Look for impaired circulation </li></ul></ul>
  4. 4. <ul><li>X-ray: (Rongentogram) </li></ul><ul><ul><li>At least two views </li></ul></ul><ul><ul><li>See joints above and below the affected limb. </li></ul></ul><ul><ul><li>Define the type of the fracture… </li></ul></ul><ul><ul><ul><li>Displacement, Angulation, Shortening, Rotation. </li></ul></ul></ul><ul><ul><ul><li>Number of fragments. </li></ul></ul></ul><ul><ul><ul><li>Joint involvements. </li></ul></ul></ul>
  5. 5. <ul><li>Not all fractures need reduction </li></ul><ul><li>Fracture needs Reduction </li></ul><ul><ul><li>Fracture involving joints. </li></ul></ul><ul><ul><li>Angulation more than 15 degree </li></ul></ul><ul><ul><li>With any rotation deformities. </li></ul></ul><ul><li>Aim to get correct alignment. </li></ul><ul><ul><li>Before manipulation—study x-ray carefully </li></ul></ul><ul><ul><li>Manipulate gently, firmly and purposefully. </li></ul></ul><ul><ul><li>Check reduction with x-ray </li></ul></ul><ul><li>If dislocation, check stability after reduction </li></ul>
  6. 7. <ul><li>BANDAGE </li></ul><ul><li>BACK SLAB </li></ul><ul><li>TRACTION </li></ul><ul><li>EXTERNAL FIXATION </li></ul><ul><li>INTERNAL FIXATION </li></ul>
  7. 8. <ul><li>It begins soon after injury. </li></ul><ul><li>Speak to the patient gently, tenderly and confidently. </li></ul><ul><li>Remove anxiety and fear. </li></ul><ul><li>Do not cause pain by handling the limb carelessly. </li></ul>
  8. 9. <ul><li>Plaster of Paris is prepared from Gypsum, which is a crystalline form of calcium sulphate, by heating to 130°C. The heat drives off water of crystallization leaving white plaster of Paris powder. </li></ul><ul><li>CaSO4.2H 2 O+ Heat (130°C)---> CaSO4.½H 2 O + 1. ½ H 2 O </li></ul><ul><li>When P/P is immersed in water , it is gradually converted back into Gypsum as water is absorbed by it to re-form crystals. Then there is production of Heat which can be felt as the cast is setting. </li></ul><ul><li>CaSO4.½H 2 O + 1. ½ H 2 O---------> CaSO4.2H 2 O+ Heat </li></ul>
  9. 10. Plaster of Paris Powder Commercial Pack
  10. 11. <ul><li>Immobilization of fractures </li></ul><ul><li>Post-operative fixation </li></ul><ul><li>To prevent or correct deformity </li></ul><ul><li>As a supporting splintage </li></ul><ul><li>To immobilize infected limbs, e.g. osteomyelities, cellulitis </li></ul><ul><li>To take a cast for splint moulding or for record purposes. </li></ul>
  11. 12. <ul><li>Advantages: </li></ul><ul><ul><li>It can be used individualized. </li></ul></ul><ul><ul><li>It is durable , if taken proper care. </li></ul></ul><ul><ul><li>It is disposable </li></ul></ul><ul><ul><li>It is partially X-ray translucent. </li></ul></ul><ul><li>Disadvantages: </li></ul><ul><ul><li>The skin cannot ‘breathe’, become scaly and itchy. </li></ul></ul><ul><ul><li>It is heavy and difficult to keep clean and dry. </li></ul></ul><ul><ul><li>There can be complication like osteoporosis, pressure sore, muscle wasting and joint stiffness. </li></ul></ul>
  12. 13. Cast is Translucent under X-ray Plaster Sore
  13. 14. <ul><li>Contact Doctor immediately if you feel.. </li></ul><ul><ul><li>The toes or fingers become blue or swollen. </li></ul></ul><ul><ul><li>You are unable to move your limb </li></ul></ul><ul><ul><li>The limbs become painful </li></ul></ul><ul><ul><li>You feel ‘ pins and needle’ or numbness. </li></ul></ul><ul><ul><li>Any blister like pain </li></ul></ul><ul><ul><li>Discharge or wetness under the cast </li></ul></ul><ul><ul><li>If you drop any object under the cast. </li></ul></ul>
  14. 15. <ul><li>Exercise the joints not under the cast. </li></ul><ul><li>Do not let the limb hang down especially first few days. </li></ul><ul><li>Do not wet the cast </li></ul><ul><li>If the cast becomes cracked, soft or loose conact the Doctor. </li></ul>
  15. 16. Plaster for the upper limb <ul><li>From </li></ul><ul><li>½ “ proximal to MP Joints </li></ul><ul><li>To </li></ul><ul><li>1” below bend of the elbow, diagonally if necessary to allow unimpeded flexion of elbow joint </li></ul>Dorsal Slab or Back Slab
  16. 17. Plaster for the upper limb <ul><li>From </li></ul><ul><li>½ “ proximal to MP Joints and distal Palmar crease. </li></ul><ul><li>To </li></ul><ul><li>1” below bend of the elbow, diagonally if necessary to allow unimpeded flexion of elbow joint </li></ul>Fore-arm Plaster
  1. A particular slide catching your eye?

    Clipping is a handy way to collect important slides you want to go back to later.

×