Orthopedic Cast, Braces, and
Traction Application
Prof. Rommel L. Salazar, DrPH A cademics.
T ouches heart.
College of Nursing E ducates mind.
A rticulates vision.
De La Salle Medical and Health Sciences Institute M odels excellence.
Learning Objectives
At the end of the session, the learners will be
able to :
a. Define cast, braces, and traction
b. Identify the different types and indications of
casts, braces, and tractions
c. Discuss the nursing considerations in the
application of casts, braces, and tractions
2
CASTS
BRACES
TRACTION
3
4
• Supportive devices
used to help keep
an injured bone in
CASTS place while it heals.
5
Cast
v a hard circular dressing with
soft padding inside of it used
to immobilize body parts
v immobilizes and protects
until healing occurs
v usually made from Plaster
of Paris of fiberglass material
6
Splint
v a half cast used to
temporarily
immobilize and
protect body parts
7
Purposes of Cast and Splint
Ø Promote healing
Ø Provide immobilization
Ø Protect the injury
Ø Prevent further injury
Ø Decrease pain
Ø Maintain bone alignment
Ø help compensate for
surrounding muscular
weakness
8
Standard Materials and Equipment for Splint
and Cast Application
▷ Plaster of Paris or
fiberglass casting
material
▷ Wadding sheet Plaster of Paris Fiberglass Cast
▷ Stockinette
▷ Basin of water at
room temperature
▷ Bandage scissor
Wadding Sheet Stockinette
9
Precasting Procedure
Ø Complete neurovascular assessment
Ø Wounds should be covered with sterile dressing
Ø For acute fractures, immobilize the joint above
( proximal) and below (distal) the fracture when
possible
Ø Explain the procedure to the client
10
Guidelines for Proper Cast & Splint Application
Ø Use appropriate amount of padding
Ø Properly pad bony prominences and high
pressure areas
Ø Properly position the extremity before, during
and after application of materials
Ø Avoid tension and wrinkles on padding, plaster
and fiberglass
Ø Avoid excessive molding and indentation
11
Patient Education
Educate client on basic
signs of Compartment
syndrome :
§ Pain,
§ Pressure,
§ Paresthesia
§ Pulselessness,
§ Swelling
12
Compartment Syndrome
Ø a condition where there is
increasing pressure within
a muscle compartment,
which eventually leads to
the death of muscle tissue
13
Taking care of your splint or cast
v Keep your splint or cast dry
v Do not walk on a walking cast until it
is completely dry and hard
v Keep dirt, sand, and powder away
from the inside of your splint or cast.
v Do not pull out the padding from your
splint or cast.
v Do not stick objects inside the splint
or cast. Do not apply powders, lotion
or deodorants to itching skin.
14
Window
A window may be cut
into the cast :
ü Wound care
ü Pressure sores
ü Checking pulse
ü Breathing window
in a body cast
15
Cast Immobilization
• circumferential cast enclosing the trunk of the body
• may extend from the head or upper chest to groin
Body or thigh
• immobilizes an appendage by incorporating a part
of the body proximal to that appendage
Spica
• involves the upper and lower extremities
Limb
16
Body Cast
▷ For affections of
lower thoracic and
upper lumbar
spine
17
Rizzer’s Jacket Cast
▷ For severe
scoliosis
18
Minerva Cast
▷ For affections
of cervical and
upper dorsal
spine
19
Shoulder Spica Cast
▷ For affection of upper portion of
humerus and shoulder joint
20
Shoulder Spica Mold
▷ For affection of upper
portion of humerus and
shoulder joint with
infection, swelling &
open wound
21
Single Hip Spica Cast
▷ For affections of
the hip and femur
22
Single Hip Spica Mold
▷ For affections of the
hip and femur with
infection, swelling or
open wound
23
1 ½ Hip Spica Cast
▷ For affections
of the hip and
femur
24
1 ½ Hip Spica Mold
▷ For affections of the hip and femur
with infection, swelling or open
wound
25
Double Hip Spica Cast
▷ For affections of
the hip and
femur
26
Double Hip Spica Mold
▷ For affections of the hip and femur
with infection, swelling or open
wound
27
Cylinder Cast
▷ For patellar
affections
28
Short Leg
Circular Cast
▷ For affections
of ankle,
tarsals and
metatarsals
29
Short Leg Posterior Mold
▷ For affections of
ankle, tarsals &
metatarsals with
infection,
swelling or open
wound
30
Brace Cast
▷ For affections of
distal 3rd of femur
and proximal 3rd
of tibia with callus
formation
31
Long Leg Circular Cast
▷ For affections of tibia and fibula
32
Long Leg Posterior Mold
▷ For affections
of tibia, fibula
with infection,
swelling or
open wound
33
Patellar Tendon Bearing Cast
▷ For affections
of tibia –
fibula with
callus
formation
34
Quadrilateral Cast
( Ischial Weight Bearing Cast )
▷ For affections
of hip and
femur with
callus
formation
35
Delvit Cast
▷ For affections of
distal 3rd tibia-
fibula with callus
formation to allow
foot exercises
36
Basket Cast
▷ For massive or
severe bone
injuries of tibia
37
Pantalon Cast
▷ For affections
of the pelvis
38
Frog Cast
▷ For congenital
hip dislocation
39
Short Arm Circular Cast
▷ For affections
of the wrist,
carpals &
metacarpals
40
Short Arm Posterior Mold
▷ For affections of
the wrist, carpals
& metacarpals
with infection,
swelling and
open wound
41
Long Arm
Circular Cast
▷ For affections
of radius and
ulna
42
Long Arm Posterior Mold
▷ For affections of
radius and ulna
with infection,
swelling or open
wound
43
Munster Cast ( Fuenster Cast)
▷ For affections of radius and ulna
with callus formation
44
Sugar Tong Cast
▷ For humerus
swelling,
infection and
inflammation
45
Hanging Cast
▷ For
affections of
shaft of
humerus
46
Functional Cast
▷ For affections of
the shaft of
humerus with
callus formation
47
Airplane Cast ( Abductor Splint )
▷ For affections of the neck of the
humerus or for recurrent shoulder
dislocation
48
Collar Cast
▷ For cervical
spine
affections
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50
•a device used to
restrict or assist
BRACE body movement
51
Shantz Collar Brace
▷ For cervical
spine affections
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Philadelphia Collar Brace
▷ For cervical
spine affection
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Milwaukee Brace
▷ For scoliosis
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Forester Brace
▷ For affections of
cervico- thoraco -
lumbar spine
55
Taylor Brace
▷ For affections
of upper
thoracic spine
56
Jewette Brace
▷ For affections of
lower thoracic &
upper lumbar
spine
57
Chair Back Brace
▷ For affections
of lumbosacral
spine
58
Banjo Splint
▷ For peripheral
nerve injuries
59
Bilateral Long Leg Brace
▷ For post-
poliomyelitis with
residual paralysis
60
Dennis Browne Splint
▷ For clubfoot
61
Cock-up Splint
▷ For wrist drop
deformity
62
Roger Anderson External Fixator
▷ For comminuted
fracture
63
Tower’s External Fixation
▷ For fracture of the
mandible
64
Four Poster Brace
▷ For cervical and
upper thoracic
spine affection
65
SOMI ( Sterno Occipito Mandibular
Immobilizer) Brace
▷ For cervical spine
affection
66
67
• The act of pulling or
drawing which is
associated with
TRACTION counter traction.
68
Skin • Applied using a bandage to pull on
the skin when light traction is
Traction required ( Indirect traction )
Skeletal • Uses pin or wires inserted through
bone and is attached to weights,
Traction pulleys, and ropes (Direct traction)
69
Dunlop Traction
▷ Supracondylar
affection of the
humerus
70
Buck’s Extension
Traction
▷ For hip and
femur affection
71
Modified Buck’s Extension
▷ For hip and femur affection
72
Bryant’s Traction
▷ For congenital hip
dysplasia
▷ For fracture of hip
and femur among
children 6 years old
and below
73
Head Halter
Traction
▷ For cervical
affection of the
spine
74
Pelvic Girdle
▷ For lumbar spine
affection
▷ For Herniated
Nucleus Pulposus
75
Cotrel Traction
▷ Combination of
head-halter and
pelvic girdle
▷ For scoliosis
76
Hammock
Suspension
▷ For fracture
of the pelvis
77
Boot Cast
Traction
▷ For post-
poliomyelitis
with residual
paralysis
78
Halo - Pelvic
Traction
▷ For scoliosis
79
Halo - Femoral
Traction
▷ For severe
scoliosis
80
90 – 90 Degrees
Traction
For subtrochanteric
fracture of the femur
81
Zero Degree
▷ For affection of
neck of humerus
and shoulder
joints
82
Overhead
Skeletal
Traction
▷ For supracondylar
affectation of the
humerus
83
Stove in Chest
Traction
▷ For multiple rib
fracture
84
Balanced Skeletal Traction
▷ For hip and
femur
affectation
85
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