Casting

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Materials

• Plaster of Paris (Gypsum)

• Synthetic Fiberglass

Plaster of Paris

• POP was first used in orthopedics by a Dutch surgeon in 1852
• Commercially available since 1931

Advantages / Disadvantages

Plaster of Paris Synthetic - Fiberglass

• Disadvantages: * Advantages:

  • Weak * Strong
  • Long setting time - 24 hours * Quickly sets
  • Heavy weight * Light weight
  • Breaks in water * Water resistant
  • Radio-opaque * Radiolucent

• Advantages * Disadvantages

  • Blunt edges * Sharp edge
  • Moldable - for correction * Not moldable
  • Cheap * Costly

Cast Forms

• Slab
  • Applied on one side only
  • Safer if limb is swollen

• Complete

  • Applied all around the limb

• Spica

  • Covering limb and trunk
  • Encircles body part
  • Hip spica
  • Shoulder spica
  • Thumb spica

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Complications of Casting

• Immobilization
  • Muscle wasting
  • Joint stiffness
  • Osteoporosis
    • Pathological fracture
• Pressure on Nerves
• Thermal burn with Synthetic cast
  • Must use cold water with synthetic cast

Complications of Casting

• Tight Cast – Vascular Problem
  • Causes Volkmann’s ischemia

• Skin Atrophy and Scaling
• Dermatitis Skin Ulceration
• Skin Blisters

• Pressure from Cast Edge

• Pressure Sores

• Hypertrichosis - Increased hair

  • Temporary localized
  • Resolves (80% after 6m)

• Dirty cast

• Items under the cast !
  • May cause pressure sores

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Cast Saw Burns

• Too quick - old blunt blade - inexperienced technician

Cast Request Form