Plaster of Paris is a type of gypsum cement that is used to make casts and splints. It is made by heating gypsum to form hemihydrated calcium sulfate, which then hardens when mixed with water. When applied to fractures, plaster of Paris forms a hardened cast that immobilizes the bone to allow it to heal. Potential complications of casting include compartment syndrome, healing problems like malunion or nonunion, and arthritis in joints. Proper cast care involves keeping it dry, using crutches as directed, elevating the cast, and contacting the doctor if pain, swelling, or other issues arise.

1. Casting and Splinting
Dr.Mohamed Hassen
D.A.M.S(SL)

2. History seems to indicate
that, despite the name,
plaster of Paris was
invented by the
Egyptians. It was used as
an artistic decoration in
many Egyptian tombs

3. What Is Plaster Of Paris?
 The term plaster of Paris was first used in the 1700s due
to large quarry deposits of gypsum located in
Montmartre, a district of Paris, which was a leading
center of plaster at the time. Plaster of Paris has become
a generic reference that is used to describe any plaster
that is a mixture of calcined gypsum (calcium sulfate
dihydrate), sand and water. When these ingredients are
mixed together and the subsequent paste is allowed to
dry, it hardens and forms a tough coating. As tough as
plaster of Paris is when dry, it is still soft enough to be
sanded and carved

4. Any of a group of gypsum
cements, essentially
hemihydrated calcium sulfate,
CaSO4· 1/2H2O , a white
powder that forms a paste when
it is mixed with water and then
hardens into a solid, used in
making casts, molds, and
sculpture.

5. Complications

6.  Many potential complications are related
not only to wearing a cast but also to the
healing of the underlying fracture.

7. Immediate
complications

8. Compartment syndrome
 Compartment syndrome is a very serious complication
that can happen because of a tight cast or a rigid cast
that restricts severe swelling.
 Compartment syndrome happens when pressure builds
within a closed space that cannot be released. This
elevated pressure can cause damage to the structures
inside that closed space or compartment—in this case,
the muscles, nerves, blood vessels, and other tissues
under the cast.
 This syndrome can cause permanent and irreversible
damage if it is not discovered and corrected in time.

9. Signs of compartment
syndrome

10. SIX Ps.6 (P P P P P P)
 Pain
 Pallor
 Pulselessness
 Paresthesia
 Paralysis
 Puffines
in the limb - the six P's of
compartmentsyndrome

11. Severe pain
Numbness or tingling
Cold, pale, or blue-colored skin
Difficulty moving the joint or fingers
and toes below the affected area.
 If any of these symptoms occur, call
the doctor rightaway. The cast may
need to be loosened or replaced.
 A pressure sore or cast sore can
develop on the skin under the cast
from excessive pressure by a cast
that is too tight or poorly fitted.

12. Delayed complications

13. Healing problems

14. Malunion:
 The fracture may heal incorrectly and
leave a deformity in the bone at the site of
the break. (Union is the term used to
describe the healing of a fracture.)

15. Nonunion:
 The edges of the broken bone may not
come together and heal properly.

16. Delayed union:
 The fracture may take longer to heal than is usual or
expected for a particular type of fracture.
 Children are at risk for a growth disturbance if their
fracture goes through a growth plate. The bone may not
grow evenly, causing a deformity, or it may not grow any
further, causing one limb to be shorter than the other.
 Arthritis may eventually result from fractures that involve
a joint. This happens because joint surfaces are covered
by cartilage, which does not heal as easily or as well as
bone. Cartilage may also be permanently damaged at
the time of the original injury.

17. Cast and Splint Care Tips

18. Keep your Cast
Dry

19.  A wet cast becomes soft and may not hold
your limb in place. It can also cause infections
and/or rashes. To keep your cast dry, do the
following:
 Bathe as directed by your physician and keep
your cast out of the water. Covering your cast
with plastic will help.
 If the cast gets damp, pat it dry with a towel or
in the case of a fiberglass cast a hairdryer on
the cool setting will work.
 If the cast gets too wet, call your physician.

20. CAST CARE

22.  For best results, remember the following:
 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. the

23. Comfort Tips

24.  To ease the discomfort of the cast try the
following:
 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.

25. When to call your Doctor

26.  If you should develop any of the following symptoms
please notify your physician.
 Pain or swelling or you cannot wiggle your fingers or
toes.
 Your fingers or toes change color or tingle.
 The cast is too tight or loose or has something stuck
inside of it.
 Your cast becomes wet, cracked, dented or has soft
spots.
 You get a rash or chafing on the skin around the edge of
your cast.
 You get a bad odor or itching that will not go away.

27. What constitutes elevation?
 Following an injury and/or surgery your body
develops swelling in the injured extremity. This
swelling may be quite painful and constricting in
your splint or cast. You can limit the amount of
discomfort by elevating the injured extremity.
The appropriate amount of elevation in the
lower extremity is 6-10 inches above the level of
the heart while lying flat. Appropriate elevation
of the upper extremity may include propping
with pillows while reclined or lying down. It may
also including draping your arm over your head.

28. What does RICE stand for?
 Rest - avoid the offending activity that
caused your injury
 Ice - utilize ice
 Compression - apply an ACE wrap to the
injured body part especially when you are
more active
 Elevation - utilize elevation

29. Thank you