External fixation is also known as External Coaption or
It may serve as a temporary support,first aid or as a
secondary support after surgical intervention.
While adopting scientific measures,art of constructing
an external coaptation should also be considered
Mechanical forces like
Bending,Rotation,Compression,Distraction at the
fracture site should be considered
Bending,Rotational-Cast application(joint above,joint
forces-Modified thomas splint
Fracture reduction-Minimally displaced fractures
are best suited for treatment with external
Fracture alignment-Care must be taken to keep
the fractured bones in proper alignment by
ensuring proper joint alignment.
It should be applied keeping limb in neutral
standing position(over extension,over flexion
should be avoided)
Joint above and joint below of a fracture must be
The primary indication for the Ehmer sling is to provide stability following reduction of
a cranial and dorsal dislocation of the hip joint.
•To provide abduction and internal rotation of the femur and flexion of
the knee, places the femoral head into a position with in the acetabulam.
•The Ehmer sling is not useful with ventral dislocation of the hip, since
abduction of the leg would be contraindicated and may cause reluxation
• The Velpeau sling is a shoulder bandage that will relieve the
forelimb of weight bearing. It keeps the carpus, elbow, and
shoulder joints in a flexed position
Immobilization of scapular fractures.
Dislocations of the shoulder joint.
1. The bandage is started by applying the combine roll around the
dorsal surface of the dog's radius and ulna.
2. Moves up over the shoulder and around the thorax behind the
opposite front leg, around to cover the flexed carpus, over the
shoulder, around the thorax once more.
The sling is then taped to the body wall in a
way that prevents the elbow from coming out
FIG. 15-3 Application of a Velpeau sling. (A) The Velpeau sling is shown with the
first revolution in place. (B) The finished Velpeau sling, with the second and third
Casts is used for providing immobilization, especially after
Casts immobilize the joint above and the joint below the area that
is to be kept straight and without motion
plaster - white in color.
fiberglass - comes in a variety of colors, patterns, and designs
STEP WISE PROCEDURE FOR APPLYING CAST:
Strips of adhesive tapes are placed on the cranial and caudal surface
of foot and allowed to protrude several inches distal to end.
An orthopedic stockinette is applied to the limb with extra length at
top and bottom.
• Cotton padding is applied to the limb starting from toe to upward.
• Wetted plaster of paris is rolled on to the limb from disital to
proximal portion and then return distally.
• After hardening stockinette and tape on the digital end are reflected
proximally and fixed with single strip of plaster splint.
• A final row of plaster may be applied and smoothed in place
FIBRE GLASS CASTING
1. Place adhesive stirrups on the limb.
2. Cover stirrups with stockinette.
3. Apply cast padding firmly over the stockinette using an overlaying
4. Place four to six layer of casting material on the limb.
1. The Schroeder-Thomas splint can be used to immobilize any
fracture distal to the midfemur or midhumerus.
2. It is also a useful device for immobilization of joints distal to
the elbow (including elbow joint) in fore limb.
3. Schroeder-Thomas splint can be useful in immobilizing distal
femoral or tibial fractures in hind limb.
Fore limb model
Hind limb model
The frame of the splint is made of aluminum rods should be
sufficiently stiff that it will not bend.
The first important component to manufacture for the splint is the
upper ring, which encompasses the thigh.
The ring should be constructed in a round fashion.
Bend the ring in an approximately 45¡ angle and flatten the ring so
that it will conform to the dog's body.
The ring should cover the tuber ischii caudally and tuber coxae
proximally in case of hind limb.
Bending of lower ring should be in the contour of limb otherwise it may
act as a fulcrum to create other complecation.
Tape is usually applied to the ring .
The outside of the aluminum frame is covered with adhesive tape .
Basic principle behind modified thomas splint is
traction with immobilisation after proper
alignment of bones.
In fore limb-Anterior arm of thomas splint should
be kept straight, posterior arm should be bent
according to the contour of leg.
In hind limb –Posterior arm should be kept
straight while the anterior arm should be bent
according to the contour of leg.
Positioning of limbs while applying the splint
should be maintained in such a manner that the
inter digital space of the leg should remain
parallel to ground so that bone alignments will
Methods of application is almost similar to that
of small animal.
Mostly made up of G.I wire-5mm to 15 mm
-Jute coils or used cloths
-Good quality gauge bandages
-Plaster of paris
OTHER SPLINTS INCLUDE
• A.METAL SPOON SPLINT
• B.SPICA SPLINT
• C.SPOON SPLINT
Spica splint is used for temporary
immobilisation in fracture of hip,shoulder joint
along with femur and humerus.
Spica support bandage requires extra
manipulation so heavy sedation under G.A is
Reduces soft tissue trauma caused by
movement of fractured fragments.
Strips of adhesive tapes are attached to medial
and lateral surface.
Cotton roll bandaging from toe to thorax.
Elastic gauge compresses and confirms the
Splint rods or cast materials extends from toes
to midline of thorax to reinforce the splint.
Wrap with a layer of vent wrap again.
ADVANTAGES OF SPLINTS
•Keeps leg in normal walking angle.
•Allows weight bearing of affected limb.
•Immobilizes limbs for wound healing, burn
therapy and skin grafts
•Provides extra support for fractures of the lower
•Provides easy access for daily wound therapy.
•Lightweight construction increases patient
•Prevents knuckling of lower limbs associated with
The Robert jones bandage provides excellent
support in an injured extremity before or after
Bulk and mild compression provides support
and reduce swelling.
It extends from the toes to mid humerus or mid
femur-provides temporary support for
fractures below elbow and stifle joint.
MODIFIED ROBERT JONES BANDAGING
•Place strips of tape on the distal 1/3rd of the
limb overlapping the toes and extending
approximately an equal length from the end
of the leg.
• Wrap the leg lightly with cast padding starting at the
toes and moving proximally. Overlap the bandage 50% as
you wrap and try to get 2 layers of padding. Note - it is
important not to exceed approximately two layers of cast
padding. Excessive padding will cause premature
loosening of the bandage as the cotton compresses
• Wrap the leg tightly with a conforming bandage
starting at the toes and moving proximally. This
is the step where you create compression.
Overlap the bandage 50% as you wrap and make
sure the toes are still visible
• Separate the strips of tape , rotate them proximally, and
secure them to the compression bandage thus creating a
barrier and preventing the bandage from slipping down
the leg in vent wrap starting at the toes at an angle to cover the
distal ends of the bandage and again moving proximally as
A Robert jones bandage is frequently
reinforced with rigid materials like aluminium
splint rods to enhance immobilisation of joints.
Advantage-Large bulk and weight of
conventional bandage is avoided.
Strips of tape must never be applied in a
circumferential manner because it may obstruct
Cotton padding should begin from toes and
then gradually wrapped around the limb and
continued proximally upto the lebel of the mid
shaft femur or humerus.
The nails of two middle toes should remain
barely visible to access post bandaging
vascular blood supply.
Too much of excessive tension should not be
applied while final covering with elastic tape
which may hinder the vascular supply.
ADVISE OWNER FOR
• Clients should be instructed to observe any
• Warmth, swelling
• Bandage should be clean and free from moisture
• Cover bandage when animal go outside
• In Robert jones bandaging technique watch toe twice a
• The site also observed for irritation and any discharge
• Advice owner to put E-collar to animal to prevent self
Loss of hair around bandaging area.
Erythematous lesion also found in bandaged
Fundamental Techniques in Veterinary Surgery
by Charles D Knecht,John R Welsor,Algernon
Text book of Surgery by Douglas Slatter
Small Animal Surgery by Theresa Welch