Plastering the leg. Plaster casts

A broken arm is a common injury. For example, adults often break their arm when they try to prop it up during a fall to soften the blow. Arm fractures often occur in children during outdoor games or as a result of falling from a bicycle or tree. When treating a fracture, it is important to immobilize the arm with a plaster cast so that the bone heals properly.

Steps

Part 1

Recognize an arm fracture. As a rule, a fracture of the arm is very easy to detect. If you suspect you or your child has a broken arm, go to an emergency room immediately. An arm fracture can be identified by the following symptoms:

• Very severe pain
• Bruise
• Dizziness or confusion immediately after injury
• Unusual bend of the arm
• The victim is unable to move his wrist or fingers
• A clicking or grinding sound at the time of injury
• Bleeding, bone fragments emerging from under the skin

1. On the way to the hospital, provide the victim with maximum comfort. Remember that in the case of a complex fracture, anesthesia may be required while the doctor moves the bone fragments back into place. Therefore, do not give the victim anything to eat or drink.

   • Use an ice pack to reduce pain and swelling. Wrap a bag of ice or frozen peas in a towel. Apply it to the damaged area for 20 minutes, then let the skin warm up.
   • To make it easier for the victim to support the broken arm, prop it up with something or make a sling from a large towel. Do not move your injured arm to avoid aggravating the injury.

2. Wait while the doctor splints your arm. The doctor will immobilize the injured arm with a splint and examine the fracture. This splint is closed on one or both sides but open on the other in case the swelling increases. The tire consists of the following layers:

   • A soft bandage that protects the skin from irritation
   • Soft lining
   • Plaster or fiberglass to support the arm
   • Elastic bandage that holds splint fragments in place

3. Have your doctor examine your injured arm. The doctor will examine your broken arm, gently feel it, and may order an X-ray. An x-ray will allow the doctor to see the bones in the arm and determine whether they need to be moved so they can heal properly.

   • For minor fractures where the bones remain in the correct positions, there is no need for additional procedures before placing the arm in a cast.
   • If the bones have moved out of their correct positions, the doctor will administer local or general anesthesia. After this, he will try to return the bones to the correct position.
   • If the doctor is unable to move the bones back into place, surgery may be necessary. Most often, the need for surgery occurs for joint fractures. Surgery may also be necessary if the bones need to be held in place using wires, plates, screws, or pins.

Part 2

1. Ask your doctor what type of bandage he plans to apply. Depending on which bone is broken, a short or long cast may be required.

   • A short cast is usually used for wrist fractures. This bandage is applied from the base of the fingers to the lower edge of the elbow. Sometimes, for wrist fractures, a long bandage is used to prevent the victim from twisting the wrist and thereby disrupting the correct alignment of the bones.
   • A long plaster cast is applied for fractures of the forearm or elbow. This bandage extends from the base of the fingers to the shoulder.
   • For fractures of the humerus, a supporting bandage or bandage is used rather than a plaster cast.

2. Ask your doctor what material he plans to use. A cast is a rigid bandage that protects broken bones until they heal. In this case, for the comfort of the patient, a soft lining is placed under the hard outer shell. Two types of materials are used for plaster casts:

3. Make sure your doctor collects everything you need. He will need the following materials and tools:

   • Band-Aid
   • Scissors
   • Basin with water. The temperature of the water affects how quickly the material hardens. The warmer the water, the faster it will harden. As a rule, slightly warm water is used for plaster. For fiberglass, the water should be at room temperature or colder.
   • Gloves if the doctor is using fiberglass
   • Gypsum or fiberglass
   • Sheets or a cape to cover you without getting your clothes dirty
   • Tubular knitted plaster lining

4. Wait while the doctor prepares your hand. Before applying the cast, the doctor will prepare everything that should be underneath it.

   • First, the doctor will position the injured arm so that the bones heal properly.
   • First, the doctor will place a tubular pad on your arm. Usually it is applied so that it protrudes about 10 centimeters beyond the edges of the damaged area on both sides. For the hands, tubular pads 5-7.5 centimeters wide are used. The doctor will straighten the lining so that there are no wrinkles. If the injured area is expected to become very swollen, the doctor may dispense with the tubular pad.
   • The doctor will then apply a bandage to the injured arm. In this case, each new layer will overlap approximately 50% of the previous one, as a result of which your hand will be covered with a double layer of bandage. Your doctor may add additional layers, especially to the fingers or other areas with a lot of bone. Typically, a bandage 5 centimeters wide is used to bandage the palm, and a wider bandage (up to 10 centimeters) is applied to the arm above the palm. In this case, the bandage should protrude from under the applied plaster by 4 centimeters on both sides. It should not interfere with normal blood circulation.

5. Watch as the doctor applies the plaster. He will wrap the bracing material around the injured arm. In this case, each new layer will overlap the previous one by approximately 50%, and the result will be a double layer without any gaps. Before the last wrap, the doctor will fold back the edges of the tubular pad and bandage, and then apply the final layer to them. After applying the fixing material, the doctor will compress it and give it the required shape. He will pay special attention to the density of the bandage:

   • If the cast is too tight around the arm, it will impede blood circulation and lead to skin irritation.
   • If the cast is too loose or has too much padding underneath it, it will slide around your hand and rub against your skin, which can cause scratches and blisters.

6. If you feel the cast getting hot, tell your doctor. As plaster hardens, it generates heat, which can cause discomfort. The amount of heat generated is determined by two factors:

   • The rate of heat release is inversely proportional to the hardening time. This means that the longer the plaster hardens, the less heat is released per unit time.
   • The amount of heat is directly proportional to the number of layers applied. That is, the thicker the gypsum, the more heat will be released when it hardens.

Human life, unfortunately, is often accompanied by injuries. The human body is a fragile vessel, there are many reasons why it can break. One of the most common household injuries is fracture of the bones of the upper and lower extremities.

In this case, a bandage using medical plaster is widely used.

Medical gypsum is a white or yellowish powder, without impurities, finely ground, soft and dry. Traumatologists make plaster casts in the operating room: they roll out a wide gauze bandage and rub plaster powder into it, then lower it into a basin of warm water.

After the bandage gets wet, it must be pulled out of the water, holding it at opposite ends so that the plaster does not leak out.

Apply plaster from above or below, rolling out the bandage in a circular motion so that one round of the bandage covers the previous one by at least half its width. Immediately straighten folds and irregularities with your hands and shape the edges of the bandage.

A plaster cast is applied directly to the skin, bandaged without tension, and the protrusions of the bones are covered with cotton wool or gauze.

If the plaster cast is applied correctly, it will not cause feelings of pain, numbness, etc. The fingers on the limbs are left open (for visual control).

If the plaster is applied incorrectly, the fingers may turn blue, lose sensitivity, and the exposed area may swell. Then the bandage is cut and must be replaced.

A type of plaster cast is a circular plaster cast. It is used if there is an open wound or other damage on the broken limb.

To monitor its behavior and condition, treatment and care, a window is made in the plaster cast while it is damp, cutting it out with scissors. This bandage is called fenestrated.

For injuries to the knee or elbow joints, apply splint- a circular plaster cast covering one joint. When applied correctly, it should cover the overlying segment of the limb to the upper third and the underlying one to the lower third, and its base is plaster splint.

To remove the plaster, you need to use a special set of tools. With their help, the bandage is cut, the edges are moved apart, and the limb is freed.

Remains of plaster on the skin are removed with water and soap.

When wearing a cast for a long time, muscle wasting and contracture of dehydrated joints occur. Therefore, it is necessary to undergo a course of physiotherapy and exercise therapy.

Plaster technique is using plaster. Plaster cast is widely used for treatment in orthopedics and. This bandage is well modeled, provides reliable fixation, fits tightly and evenly to the body, hardens quickly, is easily removed and can be applied in any conditions.

Medical gypsum, used in gypsum technology, is a semi-aqueous sulfate salt obtained by calcining natural gypsum stone at a temperature of 130°. Medical gypsum is a finely ground white or slightly yellowish powder, without impurities, dry, soft to the touch, should harden quickly and be durable in the product. These qualities are determined by inspection, palpation and using a special test. Warm water is added to the gypsum in a ratio of 2:1 until a plastic mass is formed, which should harden within 5-6 minutes. Hardening of the plaster too quickly (in 1-2 minutes) is undesirable, since plaster made from such gypsum can harden during bandaging. The frozen mass should break easily, not stretch between your fingers and not release moisture. Poorly ground gypsum with impurities is sifted through a fine sieve. Slow hardening of gypsum can be eliminated by adding hot water or alum at the rate of 20 g per bucket of water. It is necessary to know the rate at which the gypsum you are working with hardens and adjust the water temperature accordingly.

Plaster casts are applied in a special room - a plaster room, where there is a cabinet for storing plaster and plaster bandages, a table for preparing plaster splints, basins for soaking plaster bandages, tools for removing and cutting plaster casts, a couch or a special orthopedic table.

Plaster bandages are either factory-made or made on site by rubbing plaster powder into regular edgeless gauze bandages (Figure 1). To make a plaster cast, plaster bandages or plaster splints are dipped deep into a basin of warm water (Fig. 2). Wetting of the bandage is determined by the cessation of air bubbles. Remove the bandage, grasping it at both ends so that the plaster does not leak out. Bringing your hands together, squeeze out the excess water.

Rice. 1. Plastering and folding bandages.

Rice. 2. Soaking and removing the plaster bandage.

Plaster casts are applied without lining directly to the skin, covering the bony protrusions with special cotton pads (Fig. 3); Sometimes in orthopedic practice thin layers of cotton wool are used.

To apply a plaster cast, plaster splints are often used, prepared from 6-8 layers of soaked plaster bandage. The length of the splint is 60 cm - 1 m. The splint is secured with plaster or regular gauze bandage. They bandage without excessive tension and constrictions, rolling out the head of the plaster bandage in a circular motion in an upward or downward direction, covering the previous round with the next round of the bandage by at least half of its width, while straightening the folds and smoothing out the rounds of the bandage. At all times, it is necessary to carefully model the wet bandage along the contours of the body. After applying a plaster cast, it is necessary to carefully monitor the state of blood circulation in the limb, paying special attention to the fingertips: pain, loss of sensitivity, coldness, swelling, discoloration with pallor or cyanosis indicate compression of the blood vessels and the need to change the bandage.

Rice. 3. Areas of the body to be protected when applying a plaster cast.

The plaster bed is used for diseases of the spine. 5-6 large splints are made in two layers each, length from the crown to the middle of the thighs and a width slightly greater than 1/2 of the chest circumference. The patient is placed on. Bone protrusions are protected with cotton wool, and the head, back, and hips are covered with two layers of gauze. A plaster splint is placed on top of the gauze and modeled well (Fig. 4). Then subsequent layers are applied one by one. After hardening, the plaster bed is removed and cut so that the patient enters it to the middle of the crown, and the ears remain open; from the side, the edges should reach the crests of the iliac bones and axillary cavities, but in such a way that movements are not limited. An oval notch is made in the area for ease of use of the vessel (Fig. 5). After cutting, the edges of the plaster crib are covered with gauze and rubbed with plaster slurry. The dried plaster crib is covered with soft material from the inside.

Rice. 4. Making a plaster crib.

Rice. 5. Plaster crib.

A plaster corset is applied for diseases and... The type of brace is determined by the location of the lesion (Fig. 6). The corset is applied on a special orthopedic table or in a frame, which allows you to unload and eliminate the deformation (Fig. 7). The iliac crests, spinous processes of the vertebrae, shoulder blades, and collarbones are first protected with quilted pads. For a corset, wide plaster bandages or specially cut splints are used; they are alternately applied in 4 layers at the back and front, carefully modeling. The bandage is strengthened with 1-2 layers of plaster bandage. The corset contains about 20 bandages 25 cm wide. A correctly applied corset has 3 points of support at the bottom - the crests of the iliac bones and the pubis, at the top in front it rests on the sternum. A window is usually cut out in the abdomen to make breathing easier. When applying a corset-collar, the patient's collar must be open. The collar corset is cut so that at the top it ends slightly above the back of the head, below the ears and at the level of the chin, at the bottom - at the level of the XI-XII thoracic vertebrae.

Rice. 6. Types of plaster corset depending on the level of damage (indicated by an arrow).

Rice. 7. Application of a plaster corset.

Rice. 8. Coxite dressings.

In the area of ​​the shoulder girdles and armpits, the corset is cut so that movements in the shoulder joints are not limited.

The hip, or so-called coxitis, bandage (Fig. 8) is used for disease or damage to the femur. For a coxite bandage, you need wide plaster bandages, 60 cm or 1 m long plaster splints and cotton pads for laying in the area of ​​the sacrum and iliac crests. The first 2-3 long splints are placed around the abdomen and pelvis and secured with circular rounds of plaster bandage. Then two meter splints are applied along the back and outer surfaces of the lower limb to the lower third and fixed with a plaster bandage. Two short splints are used to strengthen the anterior and inner surfaces of the hip joint; one of them runs obliquely, forming the perineal part of the bandage. Short splints are applied in front from the lower third of the thigh to and behind from the middle third of the shin to the tips of the fingers. All splints are reinforced with rounds of plaster bandages. The bandage can be made from a smaller number of splints, but using a larger number of bandages. Particular strength is required in the groin area, where bandages often break.

A thoracobrachial bandage (Fig. 9) is applied for fractures in the area of ​​the shoulder joint and humerus. They begin by applying a plaster corset, then place a long splint along the inner surface of the arm from the hand to the axillary cavity, transitioning to the corset. The second splint is applied along the posterior outer surface from the hand through the shoulder to the corset. The splints are fixed with a plaster bandage and the bandage is strengthened with additional splints at the shoulder joint. A wooden stick - a spacer - is placed in plaster between the corset and the elbow joint.

Rice. 9. Thoracobrachial bandage.
Rice. 10. Circular plaster cast for damage in the elbow joint.
Rice. 11. Circular plaster cast for fractures of the forearm bones.

Circular plaster casts are widely used for fractures of extremity bones (Fig. 10, 11, 12). A circular plaster cast applied directly to the wound is called a blind plaster cast. Along with the immobilization of fragments, such a dressing protects the wound from secondary infection, protects against drying and cooling, eliminates the need for dressings, providing optimal conditions not only for the fusion of bone fragments, but also for the healing of soft tissue wounds. A blind plaster cast is widely used for the treatment of gunshot injuries and facilitates the transportation and care of the wounded.

Rice. 12. Circular plaster casts for fractures of the lower leg bones.

To observe the wound or the site of damage, a window is sometimes made in a circular plaster cast - a fenestrated bandage (Fig. 13). It is cut out with a knife in a bandage that has not yet hardened in the intended area. To make it easier to cut out the window from the inside, a cotton pad is placed, and the plaster cast in this place is made thinner. The edges of the window are rubbed with plaster slurry.

A bridge bandage (Fig. 14) is a type of window bandage, when to strengthen the bandage, metal or cardboard-plaster arches, plastered into the bandage, are thrown through the window.

Rice. 13. Window bandage.
Rice. 14. Bridge bandage.
Rice. 15. Plaster splint for the knee joint.
Rice. 16. Removable plaster splint. >

A circular bandage that covers only one of the joints of a limb is called a splint, and one that does not cover any joints is called a sleeve. The latter is applied mainly as part of complex dressings.

In case of damage and disease of the joints, most often the elbow, a splint is applied (Fig. 15), which creates complete rest for the joint. It should cover the overlying part of the limb to the upper third and the underlying part to the lower third. The splint is based on a plaster splint, over which it is bandaged with plaster bandages.

A removable plaster splint (Fig. 16 and 17) is made from a wide plaster splint, which should cover 2/3 of the circumference of the limb. The splint is well modeled on the limb and fixed with a gauze bandage. If necessary, you can easily remove the bandage by unwinding the bandage. A removable plaster splint is widely used in pediatric practice.

Rice. 17. Removable plaster splint (fixed with a bandage).

To gradually eliminate some forms of deformities and contractures, a staged bandage is used. There are several types of such a bandage. For example, when treating congenital clubfoot in young children, the foot is removed from the vicious position as much as possible and a plaster cast is applied to it in this form. After some time, the bandage is removed, the vicious position is eliminated again and a plaster cast is applied. So gradually, gradually changing the plaster casts, the foot is brought to its natural position. Another type of staged bandage, used to eliminate contractures in joints and angular deformations of bones, is a circular plaster cast with a cutout above the area to be corrected. The direction of the cut should be opposite to the deformation angle. Gradually reducing the size of the cutout using levers plastered in a bandage eliminates the deformity.

After treatment is completed, the plaster cast is removed. There is a special set of tools for this purpose (Fig. 18). When cutting a plaster cast with special scissors, the inner branch must be parallel to the bandage at all times (Fig. 19). In areas with pronounced curvature, it is better to use a saw. After cutting, the edges of the bandage are pulled apart and the casted part of the body is released. Remains of plaster are removed with warm water and soap.

Rice. 18. A set of tools for removing and cutting a plaster cast.

Rice. 19. Dissection of the plaster cast.

Even the most advanced medicines will not heal a bone fracture and wound if new tissue is not formed, so successful healing is impossible without the participation of the human body itself.

Treatment of bone fractures is a long process, from several weeks to several months, during which complete fusion of bone fragments occurs. The skin, muscles, ligaments and tendons usually heal faster. One of the simplest remedies for fractures, dislocations or curvature of a bone is a plaster cast (splint).

Soft tissues are sewn together with surgical threads or staples are used to connect them. If these methods are not possible, medical glue or laser beams are used. The bones are first returned to their natural position, then fixed with splints. Later, the natural healing process begins and the bones heal. In children and young people, the healing process is faster.

Plaster casts are used to immobilize injured limbs. They are very hard and quite heavy, the main component is calcium sulfate. Such fixing splints are applied to the affected part of the body. When hardened, a solid frame is formed, ensuring complete immobilization of the bones and their slow healing. Plaster splints are used to immobilize and fix the limb in the required position in case of chronic diseases with signs of wear and tear, for example, inflammation of the tendon sheaths.

Overlay procedure

There are a circular plaster cast, the application of which uses circular tours of a plaster bandage around a part of the body, an abduction plaster cast, the application of which helps to abduct the limb from the midline of the body, and a plaster splint. When applying a regular plaster splint, a bandage covered with a layer of plaster is immersed in water, then the affected part of the body is bandaged in a circular motion, forming a kind of frame. To prevent the plaster from sticking to the skin, a cloth is placed under it. When a tight bandage is applied, blood circulation may be impaired as a result of the hands or feet swelling, becoming pale or bluish in color, freezing, and becoming immobile. In this case, the bandage must be removed.

It is not always possible to immediately apply a plaster cast. You often have to wait several days for the wounds to heal and the swelling to shrink.

Plaster is used to correct spinal curvatures and for immobilization. A plaster bed is made from plaster gauze in the shape of the back in the form of a trough, which is placed on the patient lying on his stomach.

Synthetic resin dressings are applied in the same way. The only difference: the necessary stability is provided not by water and gypsum, but by synthetic resins and a hardener. When the cast is removed, the patient usually does not experience pain: the plaster frame is carefully cut or scored, and then broken. The area of ​​bandages applied to the hands, arms, feet and legs is usually larger than the affected area. This is done so that the bones do not separate under the tension of the muscles and tendons.

How to wear a plaster cast?

• The longer the cast is worn, the more the muscles weaken, so after removing the bandage, the muscles need to be trained.
• The cast is usually worn for a long time, so the bandage must be reapplied if the patient feels pressure and pain.
• A plaster splint does not allow you to take a bath or shower: the plaster softens in water. Water does not affect a bandage made of synthetic resins, however, it is not recommended to wet it due to the unpleasant sensations caused by the evaporation of water that gets between the skin and the plaster retainer.

If it is not possible to see a doctor for medical help for a fracture, plaster casting is performed at home. A correctly applied cast will ease the pain of a loved one, protect the wound from possible complications and allow you to postpone a visit to the doctor without harming your health. To avoid mistakes when applying a plaster cast, it is enough to choose the right materials and follow certain rules.

How to apply a cast without the help of a doctor?

To apply plaster at home, you need the following materials:

• medical gypsum in powder form,
• scissors,
• bandages, gauze of various sizes, cotton wool,
• warm water in a small basin.

It is better to learn in advance how to apply plaster correctly.

Gypsum powder is added to water in a 1:1 ratio. After stirring, check the rate of hardening of the mass. The quality of the gypsum will be optimal when it forms a solid mass within 6 minutes without the formation of crumbs.

A wide bandage or gauze is rolled out into one layer and the plaster solution is rubbed into it. Then the dressing material is rolled up in several layers and placed in a ready-made solution with a temperature just above the human body.

When the fabric is completely saturated, wring it out lightly. The bandage is now completely ready for use.

How to put a cast on your arm?

For fractures of the upper limbs, the victim must take a stable position. The bandage does not compress the skin, but at the same time it should fit snugly over the entire surface.

Rules for applying plaster to the arm:

1) a plaster cast is applied so that one edge is covered by each subsequent one;

2) the resulting folds are straightened out in a timely manner;

3) bone protrusions are leveled using a layer of cotton wool;

4) not only the fracture area is bandaged, but also the surrounding areas;

5) drying takes about 25 minutes, during which the limb is completely immobilized;

6) it is not allowed for the hand or fingers to become bluish; you must not squeeze them.

After application, the plaster should not cause discomfort. After drying, the edges of the plaster cast can be trimmed so as not to create inconvenience to the victim.