notes education

4. VARUS

5. VALGUS

6. SWELLING

7. ACTIVE ROM

9. PASSIVE ROM

10. PIN CARE
 Some types of braces, skeletal traction, and
external fixators use pins. These devices also
may have rods and clamps that help hold
broken bones in place while they heal. With
these devices, a pin makes a direct pathway to
the bone. This pathway to the bone increases
the risk of infection. If you have one of these
devices, it is extremely important to keep the
pin and the skin around it as clean as possible
to help prevent infection.

12. DEFINITION
 Pin care is the process of cleaning a pin and
the skin around where the pin enters the
body. Good care of the pin and the pin site is
very important to prevent infection.

13. PREPERATION
 Do pin care 1 to 3 times a day, as directed by
your doctor. Place the following items close
at hand before you begin:
 a clean, 4- to 8-ounce container with lid
 normal saline • hydrogen peroxide
 a pen or marker
 blue pads or a clean towelclean cotton swabs betadine
or antibiotic ointment, if ordered

14. In the container, mix equal amounts of hydrogen
peroxide and normal saline. For instance,
mix 1/4 cup of hydrogen peroxide with 1/4
cup of normal saline. Mark the container with
the name of the solution and the date it was
mixed. You may save and use the same solution
for up to 24 hours.

15. Cleaningthe area
 1. Wash your hands thoroughly.
2. Place a blue pad or a clean towel under
the area to be cleaned.
3. Clean the skin around each pin this way:
Wet a cotton swab with the solution you
mixed. Place the swab where the pin enters
the skin. Then make one stroke outward
on your skin with the swab, moving away
from the pin. Throw the swab away. Take
another swab, dip it in the solution and
make another stroke outward from the
pin.

16.  Throw the swab away. Using a new
cotton swab for each stroke, clean until
you have made a complete circle around
the pin. If the cotton swab has cotton at
both ends, you may use the other end of
the swab before throwing it out. Use each
cotton tip only once.
4. As you are cleaning the skin around the
pin, pull the skin away from the pin with
the cotton swab. Use the swab to remove
any crust at the pin site

17. Remove the crust
by making an outward stroke from the
pin site. If you need to make several
strokes to remove crust, use a clean swab
for each stroke.
5. Look for signs of infection at the pin site.
Signs of infection include redness, increased
pain, swelling, pus-like drainage, or black
tissue around the pin site

18. CONT….
 6. The next step is to clean the pin itself
with a cotton swab and the solution. Wet
the swab with the solution. Place the
swab where the pin enters the skin and
make a stroke along the pin, moving away
from your skin. Throw the swab away.
Using a new cotton swab for each stroke,
clean the entire pin.

19. CONT….
 to use if needed. Put a small amount of
the ointment on a cotton swab. Place the
swab where the pin enters the skin. Then
make a stroke along the pin, moving away
from your skin. Discard the swab. Use a
new swab for each pin.
8. Put used cotton swabs and any used blue
pads in the trash.
9. Wash your hands thoroughly.

20.  10. The solution may be saved and used again
for up to 24 hours. Be sure to seal the
container.

21. CONT….
 If you notice any of the following signs of
infection, call your doctor or nurse immediately:
• redness at the pin site
• increased pain at the pin site
• swelling at the pin site
• pus-like drainage from the pin site
• black tissue around the pin site
• fever of 101 F (38.3 C) or above
• chills

22. CAST CARE
 A cast is a structure which holds the broken bone in its
place. It also helps to prevent the muscle from contracting
and provides for effective immobilization especially after
the surgery. The casts are made of two different types of
casting materials like:
 Plaster: Is white in color
 Fiber Glass: It comes in variety of colors, shades, designs
and patterns.
 The placement of synthetic material and cotton inside the
cast make it soft and provide proper padding around the
bony structure.

24. Types Of Casts:
 A Plaster Cast: This type of cast is made up of gauze and plaster
strips soaked in water. This cast is wrapped around the injured body
part over the cotton padding. When the cast dries the strips becomes
hard to make it a solid structure. The cast takes 24- 48 hours to dry
completely.
 A Cast Brace: This type of cast is made up of hard plastic. The
compress of this brace is placed inside the soft pads which push
against the injury. The cast brace can be used immediately after the
injury happens and can also be used at the time of healing too.
 A Synthetic Cast: This cast is made from fiberglass and plastic strips.
The casts of synthetic are available in various colours and can be
easily wrapped around the injured part over the cotton padding. The
best part of these casts is that they are lighter than the plaster and dry
very fast. Thus, they take less time in becoming hard.
 A Splint: Is also known as half cast. These are made up of slabs of
plaster which hold the injured bone in one place. These types of casts
are usually used in a emergency room and can be replaced by
another type of cast very soon.

26. CARE
 Always keep your cast clean and dry by covering it with
plastic when around water and excessive dirt.
 Always use crutches and slings as directed by your physician
 Elevate the cast above your heart whenever possible
 Never slide anything inside the cast or put lotions or powders
around or inside the cast.
 Never cut the cast or pull it apart.

27.  To reduce swelling and throbbing elevate the cast above your
heart.
 Wiggle your fingers and toes to improve blood circulation.
 To relieve itching try raising the cast or changing positions or
even a blow dryer on the cool setting works. Never scratch
inside the cast.
 If your fingers or toes are cold, elevate them and cover with a
sock or blanket.

28. Traction care
Purpose-
 To regain normal length and alignment of involved bone.
 To reduce and immobilize a fractured bone.
 To lessen or eliminate muscle spasms.
 To relieve pressure on nerves, especially spinal.
 To prevent or reduce skeletal deformities or muscle
contractures

29. The physician’s order will contain:
 Type of traction
 Amount of weight to be applied
 Frequency of neurovascular checks if more frequent than
every four (4) hours.
 Site care of inserted pins, wires, or tongs
 The site and care of straps, harnesses and halters
 The inclusion of any other physical restraints / straps or
appliances (eg. mouth guard)
 the discontinuation of traction

30. types

31. Dunlop traction

32. Buck’s extension

33. Russel’s traction

35. Skin traction

36. Pelvic sling

37. Balanced skeletal traction

38. Dunlop skeletal traction

39. Thomas splint

40. Thomas splint

41. slings

42. Balkan frame