Successful Plaster Immobilization management in fracture

Successful management of fracture does not depend merely on successful reduction. Imperfect plaster immobilization has been the cause of many failures of bone union. Dreadful complications even losing the limbs can happen. These complications can be prevented by proper technique and knowledge.

Character of an Ideal Plaster

Plaster must be comfortable to the patient and should immobilize the fracture segments properly.

  1. Well fitting of plaster: The plaster case should be of light weight and must have satisfactory strength. It should cover the part of the body like a glove. Plaster must not produce any pressure or constriction on the part of the limb.
  2. Fixation of plaster: This is possible only with a plaster of adequate length. This should immobilize the joints above and below the lesion in the case of fractures of the shafts of long bones.

General Technique of Plaster Application

The plaster is applied usually after padding the area with cotton or stockinet. In some cases unpadded plaster is used for immobilization.

Cotton padding: Thin layer of cotton is wrapped round the affected part snugly. There should not be any constriction over and under the padding.

Stockinet padding: Tubular stockinet can be rolled upward over the affected part instead of using cotton pad.

Unpadded plaster: By this technique the plaster is applied directly on to the skin. The purpose is to fix the fracture properly by applying a skin tight plaster. After shaving the affected area, wet plaster is unrolled gently without producing any constriction.

Advantages of padded Plaster:

  1. Under the plaster case there remains a potential space for any swelling of the soft tissue.
  2. Moulding of the plaster can be easily without producing any compression over the affected part.
  3. The technique is comfortable for the patient.
  4. Wedging of the plaster and its removal can be done easily without producing any damage to the skin.

METHOD OF PLASTER APPLICATION

Plaster can be applied by two different methods:

    1. Plaster Slab: A plaster slab is prepared from a few layers of plaster. Once reduction of the fracture has been done, the plaster slab is applied for immobilization. In cases where there are chances of swelling and oedema to develop, the area is wrapped in cotton padding, a slab is applied and secured by a cotton bandage. This technique is more often performed in the upper limb. The plaster is completed at a later date when the condition becomes favourable, e.g., after the subsidence of oedema or after removal of sutures when these have been applied for associated soft tissue injury. Application of plaster slab also provides an added strength to the plaster. Immediate completion of the plaster during the time of fracture reduction can be done by wrapping the plaster roller bandage over the slab. This is done when swelling of the limb is not expected.
    2. Plaster Rolling: By this technique plaster is completed without applying any slab. The plaster rolls are wrapped snugly round the affected part without prior application of a plaster slab. Several turns of the plaster rolls are required to provide the adequate strength. For various type of implants used in surgery, you can visit our website www.siiora.com and we will deliver your ortho implants in India and abroad.

Peter