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Orthopedic Splints and Casts- Subhadeep PGModules.pptx

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Orthopedic Splints and Casts- Subhadeep PGModules.pptx

  1. 1. SPLINTS TRACTIONS & CASTS IN ORTHOPEDICS By: Dr. Subhadeep (PG Resident MD Emergency Medicine)
  2. 2. UPPER ARM
  3. 3. Aeroplane Splint Indication: Brachial Plexus Injury
  4. 4. Co-aptation Splint Indication: # Shaft Humerus
  5. 5. U-Cast/ Hanging Cast Indication: # Shaft Humerus U-slab: It is a U-shaped slab. This type of slab is used along with the triangular sling. The U-slab can be removed within 6-8 weeks when the Fracture is united. Hanging cast: The hanging cast is used if there is a Fracture in the lower-third of the Humerus. The weight of the limb and the cast provides sufficient traction so that the Fracture gets aligned
  6. 6. Dunlop’s Skin & Skeletal Traction Indication: # Supra Condylar Humerus
  7. 7. WRIST & HAND
  8. 8. Cock Up Splint Indication: Wrist Drop (Radial Nv Palsy)
  9. 9. Dynamic Cock Up Splint Indication: Wrist Drop (Radial Nv Palsy)
  10. 10. Knuckle Bender Splint Indication: Claw Hand Ulnar Nv Palsy + Median Nerve Palsy But Ulnar> Median Nerve Palsy
  11. 11. Turn Buckle Splint Indication: Volkman’s Ischaemic Contacture
  12. 12. Aluminum Splint Indication: Extra Articular # Phalanges
  13. 13. Mallet Splint Indication: Mallet Finger DIP Joint Kept in Hyper Extension
  14. 14. Thumb Spica Indication: • Gamekeeper's thumb • Osteoarthritis • de Quervain's syndrome
  15. 15. SPINAL CORD
  16. 16. Splints Casts and Tractions for Spinal Cord  Minerva Cast  Crutch Field Tongs  Gardenwell’s Traction  Risers Cast
  17. 17. Minerva Cast Indication: Cervical Spine Injury
  18. 18. Crutch Field Tongs Cervical Spine Injury
  19. 19. Gardenwell’s Traction Indication: Cervical Spine Injury
  20. 20. Risser’s Cast Indication: Scoliosis
  21. 21. Risser’s Cast Indication: Scoliosis
  22. 22. Milwaukee brace Indication: Scoliosis or Kyphosis
  23. 23. HIP
  24. 24. Splints Casts and Tractions for DDH  Von Rosen’s Splint  Pavlik Harness  Frog-leg Cast  Lorent’s Cast  Bachelor’s Cast
  25. 25. Von Rosen’s Splint
  26. 26. Pavlik Harness
  27. 27. Pavlik Harness
  28. 28. Frog Leg Cast
  29. 29. Loren Z’s Cast LorenZ’ s Cast Bachelors Cast
  30. 30. Bachelor’s Cast
  31. 31. Hip Spica
  32. 32. Half Hip Spica
  33. 33. Bucks Skin Traction Indication: #Femur # Leg
  34. 34. Russell’s Skin Traction Indication: #Femur # Leg
  35. 35. Bryant's Skin Traction Indication: # Femur Congenital Hip Abnomalities
  36. 36. Gallows Traction Modified overhead skin traction Indication: # Shaft Femur Given in <2 yrs age/ <12kg Body Weight Gallows traction (overhead Bryant skin traction) is useful for children younger than 2 years who weigh 10-12 kg for Fracture shaft of femur. The traction should be enough to just lift the buttocks of the child off the bed. Careful examination of the neurovascular status of the extremity is mandatory in the early period. Older children have a risk of compartment syndrome , vascular insufficiency, peroneal nerve palsy, and skin breakdown when treated with this method.
  37. 37. Cylinder Cast/ Tube Cast Indication: # Patella
  38. 38. PTB Cast Patellar Tendon Bearing Cast Indication: # Shaft Tibia
  39. 39. Ankle Foot Orthosis Indication: Foot Drop
  40. 40. Dennis Brown Splint Indication: CTEV
  41. 41. Milwaukee shoulder It is an extremely destructive arthropathy of the elderly, characterized by intraarticular or periarticular hydroxyapatite crystals and rapid destruction of the rotator cuff and the glenohumeral joint. See this case that appeared in NEJM, that of an 85 year old lady.Panel A was the X-ray finding at initial presentation when she presented with right shoulder pain & hematoma. Arthocentesis yielded a hemorrhagic non-inflammatory fluid..Culture was negative and no evidence of malignancy on cytological analysis. Alizarin red staining of the synovial fluid yielded hydroxyapatitie crystals.See Panel B for X-ray taken after 3 months showing complete destruction of the humeral head
  42. 42. Milwaukee shoulder

Editor's Notes

  •  Gamekeeper's thumb, osteoarthritis, de Quervain's syndrome, scaphoid fracture, thumb sprains, post-operative use, and post-removal of casting of the hand/thumb.
  • A hip spica cast is a sort of orthopedic cast used to immobilize the hip or thigh.
    It is used to facilitate healing of injured hip joints or of fractured femurs.
    A hip spica includes the trunk of the body and one or both legs. A hip spica which covers only one leg to the ankle or foot may be referred to as a single hip spica, while one which covers both legs is called a double hip spica. Aone-and-a-half hip spica encases one leg to the ankle or foot and the other to just above the knee.

    The extent to which the hip spica covers the trunk depends greatly on the injury and the surgeon; the spica may extend only to the navel, allowing mobility of the spine and the possibility of walking with the aid of crutches, or may extend to the rib cage or even to the armpits in some rare cases. Hip spicas were formerly common in reducing femoral fractures, but today are rarely used except for congenital hip dislocations, and then mostly while the child is still an infant.
    In some cases, a hip spica may only extend down one or more legs to above the knee. Such casts, called pantaloon casts, are occasionally seen to immobilize an injured lumbar spine or pelvis, in which case the trunk portion of the cast usually extends to the armpits.
  • Bryant's traction is a form of orthopedic traction. It is mainly used in young children who have fractures of the femur or congenital abnormalities of the hip. Both the patient's limbs are suspended in the air vertically at a ninety degree angle from the hips and knees slightly flexed.