Splints and casts: indications and methods. Thermal injury with contemporary cast application techniques and methods to circumvent morbidity. Philadelphia: WB Saunders 1992.Ĭonnolly J. Functional bracing of fractures of the shaft of the humerus. Sarmiento A, Kinman PB, Galvin ED, Schmitt RH, Phillips JG. Philadelphia: Lippincott Williams & Wilkins 2006. This review addresses midshaft fractures of the humerus in children. Some people only need a splint or cast for the bone to heal. Apply the splint material to the posterior humerus and continue past the elbow and along the ulnar surface of the forearm and. Squeeze excess water from the splinting material (do not wring out plaster). Immerse the splinting material in lukewarm water. You might need surgery to repair your bone. Alternatively, if using ready-made splint material, cut a single piece to the above length. The majority of these fractures can be treated by immobilization alone. Transverse fractures are almost always caused by traumas like falls or car accidents. Principles, purpose, and techniques will be given, as well as clinical pearls for complications of what can be overlooked as a simple and benign intervention. One of the most important features of humeral fractures in children is their ability to remodel and heal with minimal to no deformity despite displacement and angulation. However, placement of a temporizing splint by another provider may be necessary until the patient stabilizes or the team is available. An orthopedic team is available at all trauma centers and responsible for fracture/dislocation management. Assumption that a joint dislocation is reduced will be made. For this chapter and review of splinting techniques, reduction maneuvers will not be discussed in detail. In acute trauma patient care, fractures can be categorized as displaced or nondisplaced. This instructional chapter will address basic fracture principles, reduction and splinting principles, techniques for common upper and lower extremity splints, and complications related to incorrect splinting. However, precise splinting is achieved through much experience and repetition with focus on soft tissue protection and proper final positioning. This article highlights the different types of splints and casts that are used in various circumstances and how each is applied.Fracture immobilization in the acute orthopedic trauma patient is necessary for fracture reduction, joint stability, and pain control and to prevent soft tissue injury. Indications and accurate application techniques vary for each type of splint and cast commonly encountered in a primary care setting. Selection of a specific cast or splint varies based on the area of the body being treated, and on the acuity and stability of the injury. All patients who are placed in a splint or cast require careful monitoring to ensure proper recovery. HUMERAL SPLINT Provides circumferential soft tissue compression of the humerus while allowing full range of motion at shoulder and elbow. Excessive immobilization from continuous use of a cast or splint can lead to chronic pain, joint stiffness, muscle atrophy, or more severe complications (e.g., complex regional pain syndrome). To maximize benefits while minimizing complications, the use of casts and splints is generally limited to the short term. Because of this, casts provide superior immobilization but are less forgiving, have higher complication rates, and are generally reserved for complex and/or definitive fracture management. This quality makes splints ideal for the management of a variety of acute musculoskeletal conditions in which swelling is anticipated, such as acute fractures or sprains, or for initial stabilization of reduced, displaced, or unstable fractures before orthopedic intervention. Splints are noncircumferential immobilizers that accommodate swelling. This type of fracture can occur throughout childhood but is most common between the ages of 7 and 12 years old. 1 They occur with a reported incidence rate of 20. Definition Signs and Symptoms Causes Diagnosis Treatment A buckle fracture is an incomplete fracture where one side of the bone 'buckles' or bends on itself it does not affect the other side of the bone. Management of a wide variety of musculoskeletal conditions requires the use of a cast or splint. Supracondylar humerus fractures are the most common elbow fracture in children.
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