Casting

History

• Edwin Smith Papyrus dates from 2800 to 3000 BC

• Hippocrates oil mixed with wax, resin• Albucasis (Arabic physician) mill dust and

egg whites or mixtures of grain, herbs, clay• Pirogov (Russia) + Antonius Mathijsen

(Holland) 1800s POP• Lucas Championaire Life is motion

Closed Reduction

Hydrostatic pressure

6

Price Water resist

Weight

Strength

Molding

Radiology Open

plaster cheap no heavy easily broken

easy transparant +

easy

fiberglass

expensive

yes light strong no transparant saw,bevalv

e

Problem

Time Limits Consideration

• Immersion time / waktu celup : 2 - 6 seconds

• Open time/ setting time/ waktu aplikasi : 2 - 6 minutes

• Drying time / waktu pengeringan : 24 - 48 hours

Bahan & Alat

• Plaster bandage rol• Bebat elastis• Waskom terisi air bersih• Kapas padding, stockinette• Pemotong gips• Pensil • bantal

Tehnik pemasangan

• Bersihkan

• padding

• Buka ujung rol

• Pegang kedua tepi rol plaster

• Celup seluruh rol kedalam air, sampai keluar

semua gelembung udara

Tehnik pemasangan

• Kedua tepi rol sedikit diremas

• Dr Fracture site distal ke proximal atau sebaliknya

• Tebal lapis pada awalnya 2-3 lapis, dan dilanjutkan dgn ¼ lebar plaster

• Rolling secara spiral, permukaan dihapus utk diratakan.

Tehnik pemasangan

• Asisten mempertahankan posisi tungkai, tdk boleh

bergerak pada ‘critical setting period’

• Lama pengerasan tergantung jenis plaster

• Setelah plaster mengeras, tepi-tepi dipotong utk

diratakan (trimming)

• Bersihkan kulit yg terkena gips

Tehnik pemasangan

• Beri tanda lokasi fraktur, tanggal pembuatan

• Pada kasus prevensi thd sindroma

kompartemen, cast dibelah pada kedua sisi

( bivalve ) dan dibebat longgar dg bebat

elastis.

Paska plastering

• Observasi tanda sindroma kompartemen• Elevasi tungkai• Tunggu kering ( 24 – 48 jam )• Gerakan bagian distal ( jari-jari ) aktif / pasif• Jaga plaster cast agar tdk rusak• Jangan memasukkan benda / menggaruk kulit

dlm cast ( bahaya infeksi )

Paska plastering

• Evaluasi keadaan tungkai dan cast setelah 2 x 24 jam

• Hari ke 7 – 14, dilakukan evaluasi cast dan keadaan tungkai, bila cast longgar, evaluasi fraktur dgn X-ray, pertimbangkan penggantian cast dengan skin tight cast.

18

• Lower extremitya. short leg cast (below knee)

Sarmiento castb. long leg cast (above knee)• cylinder cast• hip-pelvis : hemispica cast

double spica cast

c. spine : cervical : Minerva cast th-L : body jacket

19

Walking plaster

• Sarmiento• Ankle fracture• Foot fracture

APPLICATION OF A SHORT LEG AND SARMIENTO CAST

• Support metatarsal head, 5 cm proximal to the patella. Mold the leg portion of the cast and extend the knee to 45° of flexion (more Stable)

• the lower pole in the patella and moulded around the patellar tendon

• Foot plantigrade, ankle 90 degree

• Positioning

• Padding

• Plaster Application

• Trimming

• Completed Sarmiento cast

Long Leg Cast

• Delbet Cast

• CYLINDER CAST

Weight bearing spica

Long arm cast

The cast is applied from just below the axilla to just proximal to the metacarpophalangeal joints of the digits but leaving the thumb free. The wrist is placed in 30 degrees of dorsiflexion and the elbow in 90 degrees of flexion.

Long-arm cast for Colles' fracture

Hanging cast

• The arm is placed over the lower chest with the elbow at 90 degrees.

• the top of the humeral component of the cast is above the humeral fracture.

International Training Module C1

U – Slab/Humeral Splint

• humerus in line with body• elbow at 90 degrees• palm facing chest• patient shoulders remain

square• stockinette, pad, felt• extent: axilla to over

acromioclavicular• fan slab over shoulder

International Training Module C1

U – Slab/Humeral Splint

• mould over shoulder for close fit

• apply pre-soaked retention bandage

• support with collar and cuff

• allow arm to hang• make function and

neurovascular checks

Colles/forearm cast

used for most distal radial and ulnar fractures as well as for some carpal injuries. The cast extends from below the elbow to just proximal to the metacarpal necks of the digits with the thumb left free

The short-arm cast can be used to immobilize the wrist and the base of the finger metacarpals for a host of disorders

TERIMAKASIH