ORTHOPAEDIC IMMOBILIZATION TECHNIQUES .ORTHOPAEDIC IMMOBILIZATION TECHNIQUES ORTHOPAEDIC IMMOBILIZATION

O R T H O PA E D I CI M M O B I L I Z AT I O N

T E C H N I Q U E S

O R T H O PA E D I CI M M O B I L I Z AT I O N

T E C H N I Q U E S

Nati

onal Association of

Orthopaedic Technolog

ists

A S T E P - B Y - S T E P G U I D E F O R C A S T I N G A N D S P L I N T I N G

S a m u e l A . B r ow n M.S., OTC | F r a n k R a d j a OTCMore about this book: http://www.sagamorepub.com/products/orthopaedic-immobilization-techniques?src=lipdf

O R T H O PA E D I CI M M O B I L I Z AT I O N

T E C H N I Q U E SA S T E P - B Y - S T E P G U I D E F O R C A S T I N G A N D S P L I N T I N G

S a m u e l A . B r ow n , MS, OTC

F r a n k E . R a d j a , OTC

SAGAMOREP U B L I S H I N G

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2015 Sagamore Publishing LLCAll rights reserved.

Publishers: Joseph J. Bannon and Peter L. BannonDirector of Sales and Marketing: William A. AndersonSales Manager: Misti GillesDirector of Development and Production: Susan M. DavisTechnology Manager: Keith HardymanProduction Coordinator: Amy S. DagitInterior and Cover Designer: Julie Schechter

Library of Congress Control Number: 2014950924ISBN print edition: 978-1-57167-742-6ISBN ebook: 978-1-57167-743-3

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Nati

onal Association of

Orthopaedic Technolog

ists

This publication is made possible by a partnership between the National Association of Orthopaedic

Technologists and BSN Medical Inc.

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iv

Samuel A. Brown, MS, OTCDirector Of Orthopaedic TechnologySouthern Crescent Technical College

Frank E. Radja, OTCUniversity of Illinois at Chicago

Steven M. Kane, MDChairman, Atlanta Medical CenterOrthopaedic Surgery Residency ProgramAtlanta Medical Center

Evan Siegall, MDAtlanta Medical CenterOrthopaedic Surgeon

Ken Wright, DA, ATCProfessorThe University of Alabama

Medical EditorsProf. Benson Bradley, MBA, CST, SADepartment Chair; Allied HealthAcademic AffairsDirector; Surgical Technology & Central Sterile

SupplySouthern Crescent Technical CollegeGriffin, Georgia

John F. Dalton IV, MDGeorgia Hand, Shoulder & ElbowAtlanta, Georgia

Ched Garten, MDPrimary Care Sports MedicineMyers Sports Medicine & Orthopaedic CenterAtlanta, Georgia

Authors

Contributing AuthorsSean B. Conkle, OTCPresidentNational Association of Orthopeadic Technologists

Cynthia R. Henderson, OTC, BOCO, COViscent Orthopedic Solutions

Robyn Lynn Masseth, OTCFargo VA Medical Center

Nicole T. Williams, MBA, NCQA PCMH CCE, OTCVice PresidentNational Association of Orthopaedic TechnologistsSCL Physicians

Carl Lindsey, OTCBSN Medical Inc.Clinical National Trainer, Fracture Management

Timothy J. Henderson, MD, FAAOSGotham City Orthopedics New York, New York

Clarence T. Millikin, PA,CPhysician Assistant Orthopaedic Surgery-CertifiedUniversity Orthopaedic ClinicAtlanta, Georgia

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v

Authors ivMedical Editors ivDisclaimer viiAcknowledgmentsviiiPreface ix

Chapter One: Fundamentals of Casting and Splinting Procedures 1Educational Objectives 1Introduction 1Terminology 1Injury Assessment 1Purposes of Splinting 2Presplinting Procedure2Selection of Splint Supplies 2Splinting Procedure 3Patient Instructions 4Purposes of Casting 4Selection of Cast Supplies 4Precasting Procedures 4Casting Procedure 5Patient Instructions 6Cast Removal 7Specific Cast-Cutting Procedures 9Other Important Considerations 12

Chapter Two: Upper Extremity Splints 13Educational Objectives13Introduction 13Terminology 13Splinting Techniques 13 Short Arm Volar Fiberglass Splint 14 Volar Splint PlasterReusable 16 Thumb Spica Splint 18 Ulnar Gutter Splint 20 Coaptation Splint 24 Forearm Sugar Tong Splint 27 Double Sugar Tong Splint 30 Long Arm Posterior Splint 33 Finger/Wrist Flexion Block Splint 36 Finger/Wrist Extension Block Splint or the Clam Digger Splint 38

Contents

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Chapter Three: Upper Extremity Casts .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 Educational Objectives.......................................................................................................................41Introduction .......................................................................................................................................41Terminology .......................................................................................................................................41Cast Techniques .................................................................................................................................41 Short Arm Cast ............................................................................................................................42 Long Arm Cast ............................................................................................................................46 Short Arm Thumb Spica Cast .......................................................................................................50 Short Arm Thumb Spica Cast Using Plaster of Paris .....................................................................53 Boxers Cast/Intrinsic Plus Cast ...................................................................................................56 Muenster Cast and Modified Muenster ........................................................................................60

Chapter Four: Lower Extremity Splints .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65Educational Objectives.......................................................................................................................65Introduction .......................................................................................................................................65Terminology .......................................................................................................................................65Splint Techniques ...............................................................................................................................65 Posterior SplintShort Leg ...........................................................................................................66 Posterior SplintLong Leg ...........................................................................................................69 Posterior SplintShort Leg With Stirrups .....................................................................................72 Posterior SplintShort Leg With Stirrups Using Plaster of Paris ...................................................76

Chapter Five: Lower Extremity Casts .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81Educational Objectives.......................................................................................................................81Introduction .......................................................................................................................................81Terminology .......................................................................................................................................81Cast Techniques .................................................................................................................................81 Short Leg Cast..............................................................................................................................82 Short Leg Cast Using Plaster of Paris ...........................................................................................87 Short Leg CastToe Plate .............................................................................................................91 Equinus Short Leg Cast ................................................................................................................96 PTBPatellar Tendon Bearing Cast .............................................................................................100 Long Leg Cast ............................................................................................................................107 Cylinder Cast .............................................................................................................................111

Chapter Six: Complications of Casting and Splinting .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115Educational Objectives.....................................................................................................................115Introduction .....................................................................................................................................115Incidence .........................................................................................................................................115Complications ................................................