8/14/2019 Ortho Gadgets
1/18
GADGETSMost common gadgets used at Philippine Orthopedic Center
are :
1. Cast2. Braces
3. Traction
4. Canvass
Care of Patient in Cast
Cast- is a temporary immobilization device which is
made up of gypsum sulfate anhydrous by calcinations
when mixed with water swells and forms into cement.
A. Functions-
1. to immobilize
2. to prevent or correct deformity
3. to support, maintain and protect realigned
bone
4. to promote healing and early weight-bearing
C. Casting Materials:
1. Plaster of Paris others made of:
As synthetic materials:a. Fiberglass
b. Polyester / cotton knit
c. Thermoplast
1
8/14/2019 Ortho Gadgets
2/18
D. CAST CAN BE APPLIED IN THE EXTREMITIES,
TO THE TRUNK AND TO EXTREMITY AND TRUNK ,
IT CAN ALSO BE APPLIED IN WHOLE BODY, OR
APPLIED AS A SPLINT OR MOLD.
E. Complications of Cast
1. neurovascular compromise - it
compromises the circulation and function
of the tissues within that space.
2. incorrect fracture alignment
3. cast syndrome:a. superior mesenteric artery syndrome
occurs with the body casts
b. traction on superior mesenteric
artery causes decrease in supply to
bowel
c. signs and symptoms: abdominal pain
nausea, and vomitingd. COMPARTMENT SYNDROME ( IS A
CONDITION WHICH INCREASED
PRESSURE WITHIN A LIMITED
SPACE, COMPROMISES THE
CIRCULATION AND FUNCTION OF
THE TISSUES WITHIN THE
SPACE.
2
8/14/2019 Ortho Gadgets
3/18
F. Principles in Applying Plaster cast
I. Provide for maximal comfort and alleviation
of complications.
II. Maintain desired position throughout thecast application.
Use caution in handling of the cast until
has set or become hardened. Support it
with palm.
III. Prepare the patient for the cast
application by providing appropriate
education.IV. Provide the patient with privacy, before
and during the cast application.
F. Contraindications of Plaster Cast Application
I. Pregnancy
II. Skin Disease
G. Applying a Plaster cast ( circular Cast
application)
a. Check for the doctors Order
b. Inform and prepare the patient for the
procedures.
c. Ready all things needed.
d. Position by the doctor
e. Apply padding 1st
f. Soak into the bucket with water
g. When bubbles cease, without squeezing it
3
8/14/2019 Ortho Gadgets
4/18
h. Apply cast in circular motion until the
whole area is covered and molding it,
during the process of application.
i. Handle the cast with care.
H. Care of Patient on Cast
A. The duration is at least one month .It
varies among patients. Factors that
influences the duration are:
a. Age
b. Part of the body affectedc. the degree of injury or affection of the
part.
B. During the entire period that the patient
is in Cast the nurse responsibility is
focused on the following:
a. Neuro-vascular checksb. Preservation of the efficiency of the
cast
c. Maintenance /promotion of the integrity
of he system of the body
d. Maintenance of the cleanliness of the
cast.
4
8/14/2019 Ortho Gadgets
5/18
INSTRUMENTS FOR CAST REMOVAL:
1.CAST CUTTER ( MANUAL,
ELECTRIC)
2.CAST SPREADER3.TRIMMING KNIFE
4.BANDAGE SCISSORS
5.PLASTER SHEARS
CASTS INDICATIONS
1. Collar cast Cervical spine affection
2. PhiladelphiaCervical spine affection / injury
3. Minerva cast Upper dorsal spine for potts
dis. and scoliosis
4. Rizzer Jacket castFor Scoliosis
5. Body Cast Lower lumbar spine
6. Pantalon Cast For pelvis #
7. Double Hip Spica
Cast
Bilateral affection of Hip and
femur
8. Double Hip spica moldBil. Affection of hip and femur w/
infection, swelling and open
wound
9. 1 Hip Spica cast Pelvis and hip affection
10. 1 Hip Spica mold Pelvis and hip affection
w/ infection, swelling and open
wound
5
8/14/2019 Ortho Gadgets
6/18
11. Single Hip SpicaHip and femur affection w/
infection, swelling and openwound
12. Frog castCongenital hip dislocation
13. Hanging CastFx shaft of Humerus
14. Functional Cast Fx of shaft of humerus w/c
allows flexion and extension of
upper extremity
15. Shoulder Spica CastAffection of upper portion of
humerus (recurrent dis.)
16. Airplane CastFx neck of humerus / for
abduction splint ( recurrent
shoulder dislocation)
17. Cylinder CastAffection of the patella
18. Cylinder MoldAffection of the patella w/
infection, swelling and openwound
19. Long Leg circular cast( LLCC)
For tibia and fibula
20. Long Leg posterior mold
( LLPM)For tibia and fibula w/ infection,
swelling and open wound
21. Patella Tendon Bearing
Cast ( PTB cast)Affection of tibia and fibula
22. Quadrilateral Cast
Affection of # femur23. Short leg circular cast
Ankle and toes
24. Short leg posterior moldAnkle and toes w/ infection,
swelling and open wound
6
8/14/2019 Ortho Gadgets
7/18
25. Boot CastPost polio w/ residual
26. Brace castFor # of the patella / fx distal 3rd
femur27. Basket Cast
For sever or massive bone injury
28. Delvit castAffection of the distal 3rd of tibia
and fibula
29. Internal rotatorFor pt who is udergone HIP
surgery / prosthesis,maintain abduction nad
prevent internal rotation30. Short Arm Circular cast
Affection of wrist andfinger( Wrist , carpals,matacarpals andphallenges)
31. Short Arm posterior mold Affection of wrist and
finger( Wrist , carpals,matacarpals andphallenges) w/ openwound , infection, andswelling
32. Long Arm Circular CastAffection of radius, ulna and wrist
33. Long Arm posterior moldAffection of radius, ulna and wrist
w/ open wound , infection,and swelling
34. Walking castAffection of ankle and toes w/
callus formation
7
8/14/2019 Ortho Gadgets
8/18
35. Night splintFor post polio w/ residual
36. Sugar tong
Affec tion of the shoulder , upperportion of the humerus w/open wound , infection andswelling
37. Fuenster ( Munster Cast)Fx of the radius and ulna w/
callus formation
38. U moldShaft of the humerus
39. Thumb Spica castAffection of the 1st metacarpals
bone
40. Petri castIndicated for legg perthes dis.
41. Bohler Braun splintTibia plateau pin inserted at the
calcaneous bone
8
8/14/2019 Ortho Gadgets
9/18
Traction
1. Traction is the act of pulling or drawing which isassociated with countertraction. Traction means that a
pulling force is applied to a part of the body while
countertraction pulls in the opposite direction.
The basic type of traction / Classification of
traction:
1. Skin traction is the application of a pulling force tothe skin from where it is transmitted to the muscle and
then to the bones by the use of:a. ADHESIVE TYPE / TAPE MATERIALS;
Ex. Bryan traction, Dunlop traction
b. NON- ADHESIVE TYPE LIKE:
Ex. Canvass, slings, leather and strap with buckles
and laces/ Ex of traction : Pelvic traction, Head Halter,
Hammock suspension.
2. Skeletal Traction- the pulling force is applied directlyto the bone using pins and wires such as KIRSHNERS
9
8/14/2019 Ortho Gadgets
10/18
WIRE, STEINMANS PIN, VINKIS SKULL RETRACTOR,
AND CRUTCHFIELD TONGS.
EX. affection of the femur, cervical spine or hip.
3. Manual Traction - the pulling force is applied byhands of the operator. In accident sometimes hands applied
first the EMS arrived, cervical collar applied, pulling force
during casting esp. in extremity
Purpose of Traction
1.IS OFTEN USED IN THE TREATMENT OR
FRACTURED EXTREMITIES.A.to lessen muscle spasm
B. to reduce #
C. to provide immobilization
D.to maintain alignment / support
2. IS ALSO USED TO CORRECT, OR PREVENT
DEFORMITIES AS IN CASE OF ARTHRITIS
PATIENT WITH FLEXION CONTRACTION.
A CHILD WHO HAS SCOLIOSIS AND IS PLACED
IN TRACTION TO HELP LESSEN THE CURVATURE
OF THE SPINE BEFORE CORRECTION SURGERY
IS CARRIED OUT BUT TO INSERT AHARLINGTON ROD.
3. PRIOR TO TOTAL HIP REPLACEMENT, SURGEON
MAY APPLY SKELETAL TRACTION, IN AN
10
8/14/2019 Ortho Gadgets
11/18
ATTEMPT TO STRECH MUSCLES AND OBTAIN
MORE WORKING SPACE WITH THE JOINTS.
4.IT LESSEN MUSCLE SPASM IN BACK PAIN ANDIN RESTING A DESEASED JOINT AS IN
TUBERCULOSIS.
PRINCIPLES OF TRACTION- CERTAIN PRINCIPLES
MUST BE ADHERED TO IF TRACTION IS TO BE
EFFECTIVE;
TRACTION MUST:1. Have an opposite pull or
countertraction.
2. Be free from any friction
3. Follow and established line of pull that
is the line of pull must be in line with
the deformity
4. Be continuous traction5. Be applied to a patient in a supine
position.
NURSING IMPLICATION IN VARIOUS TRACTIONS
APPLICATION
1. PHYSICIAN HAVE PRACTICED AND VERY
EFFICIENT AND EFFECTIVE.
2. NURSE MUST KNOW ALL BY MEANS MUST
BE KNOWLEDGEABLE ABOUT THE
PRINCIPLES OF TRACTION, UNDERSTAND
11
8/14/2019 Ortho Gadgets
12/18
THE ROUTINES OF THE HOSPITALS STAFF
& PHYSICIANS.
12
8/14/2019 Ortho Gadgets
13/18
TRACTIONKinds of Traction Indication Classification
13
8/14/2019 Ortho Gadgets
14/18
1. Head halter Cervical spine
affection
Skin traction /non
adhesive type
2. Pelvic Girdle Lumbo-sacral
affection(HN
P)
Skin traction / non
adhesive type
3. Halo-Pelvic For scoliosis Skeletal traction
4. Halo-femoral For severescoliosis
Skeletal traction
5. Overhead # of the humerus/
supra
condylar # of
the humerus
Skeletal traction
6. Buck Extension Femur and hip
affection
Skin traction /
adhesive-
adhesive type
7. Dunlop traction Supracondylar #
of the
humerus
Skin adhesive type
8. Bryants
traction
Cogenital hip
disloc. #
femur for 6
y.old
Skin traction /
adhesive type
9. Boot Cast ( leg) Post polio w/residual
paralysis
Special type oftraction
14
8/14/2019 Ortho Gadgets
15/18
Ninety-ninety
degrees(steinman
pin)
Fx of the femur Skeletal traction
11. Hammock
suspension
Pelvic affection Skin traction
Cotrel traction comb.
of head halterand pelvic
traction
For scoliosis Skin traction /
adhesive type
12.Balance
skeletal
traction
Hip and femur
affection
Skeletal traction
13.Zero degreetraction Neck of thehumerus Skin traction /adhesive type
14.Stove in Chest
traction
Multiple ribs # Special type
traction
15
8/14/2019 Ortho Gadgets
16/18
ORTHO-BRACES= a mechanical support for neck, muscle, bones and joints.
Braces Indications
1. Shuntz collar / cervical
Collar
Cervical affection
2. Philadelphia brace Cervical affection
3. Taylor brace Upper thoracic spine affection
( potts disease)
4. Jewette brace Lower thoracic affection
5. Milwaukee Brace For scoliosis ( thoracic T-9)
6. Yamamoto Brace For Scoliosis
7. Chair-Back Brace Affection of lumbo-sacral spine
8. Four foster Brace orWalker
Cervical thoraco spineaffection
9. Forester Brace Cervico-thoraco-lumbar spine
affection
10. Bilateral Leg Brace For Polio
11. Unilateral Leg Brace For Polio ( one leg)
16
8/14/2019 Ortho Gadgets
17/18
12. SOMI Brace
For Potts disease( sterno
occipito mandibular
Immobilizer / For cervico
upper dorsal spine affection
13. Dennis Brown Splint For clubfoot
14. Banjo Splint For Peripheral nerve injury
15. Cock-up Splint For wrist drop
16. Lively Finger splint For Fracture of finger
17. Abduction walking Brace For legg Perthess Disease
18. Bohler Braun Splint For tibia plateau pin inserted
at the calcaneum bone
19. RAEF- Roger AndersonExternal Fixator
Affection of Tibia-Fibula, Longbones, for humerus, Mal-
union, communited #
20. Towers External Fixation For # of the mandible
21. Hoffman fixator For # of the pelvis
22. Spanning fixator For Long bones ex. femur and
tibia-fibula communited #cannot flex.
23. Delta fixator
24. Hybrid fixator
17
8/14/2019 Ortho Gadgets
18/18
18