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  Sports And Injuries

July 2012
Glue On Broken Bones
Dr N Somasekhar Reddy
 
Accidents, like a fall, a bump, a twist, a crash, or a hit, while about your daily life, can land you with a fracture leaving you staring at a bleak few weeks of forced rest or immobility. What should you know about casts and splints that you have to suffer while your affected bones take their time to set?.
A cast is a protective shell of plaster of paris, fibreglass, thermoplastic, or a bandage, which is moulded to protect a broken or fractured limb as it heals. This is generally used for definitive treatment of a fracture or an injured limb after doctors have set the injury right.

A splint is a rigid or flexible device used for support or immobilisation of the displaced or movable parts of a limb or spine. It is generally a prefabricated appliance and can be used in emergencies, either after the preliminary adjustment of the fracture or simply without any adjustment of the fracture. Immediate application of a temporary cast or a splint on fracture prevents further damage or aggravation of the condition, and helps to reduce pain, swelling and muscle spasm.

Types Of Casts And Splints
Casts are custom made, as they must fit the shape of the injured limb. Plaster of paris or fibreglass can be moulded according to individual needs to make custom made splints. Plaster of paris bandages are the traditional material used to make casts and splints. The plaster can be moulded better than fibreglass and it is cheaper too; it is heavy but is not so strong. Fibreglass is lighter in weight; it is strong enough to hold the weight of a patient, and is easy to use.

Nowadays readymade splints of various sizes and shapes with velcro straps are available. They are easier to apply and are comfortable and suitable for some cases. Thermoplastic materials have the advantage of being lightweight and strong, with good cosmetic appeal.

Application Of Casts And Splints
Splints are applied, to begin with, when the injury is still fresh. A cast is applied if found necessary, when the swelling subsides. Before the application of cast or splint, it is necessary to give a protective layer of soft cotton padding and extra padding to bony prominences. The splint or cast must fit the shape of the injured limb and also cover the joints that are immediately above and below the broken bone. In some instances, the cast loosens up (when the swelling subsides) necessitating the reapplication of the cast. Left unattended, a loose cast can lead to mal-alignment of the fractured bone.

Care Of Casts And Splints
  • Do not wet the plaster.
  • Do not cut or insert any objects into the plaster.
  • When it is the fracture of the lower limb, do not walk with splints or casts on, unless you have been advised to do so.
  • When bathing, protect the cast or splint with a plastic cover or use waterproof plaster covers that are available in the market.
Warning Signs Of A Tight Cast Or Splint
In the first 48 to 72 hours of the application of a cast, you are likely to experience a sense of tightness inside the cast or splint. It is due to the injury. It is advisable to keep the injured limb elevated and do some active movements of the toes or fingers as the case maybe. Be sure to report to your doctor immediately for the following:
  • If the affected area is the cause of increasing pain and you feel that the splint or cast is too tight.
  • If there is numbness and tingling in your hand or foot.
  • If there is excessive swelling below the cast.
  • If there is loss of active movement of toes or fingers
Cast Removal
After the removal of the cast, the skin in the particular area may look dry, with layers of dead skin peeling off. Wash the area well with soap and apply moisturiser regularly for some time. There might also be stiffness of the joints and some wasting of the muscles around the affected joint; it may be addressed through physiotherapy and exercises.
Dr N Somasekhar Reddy is Consultant Orthopaedic Surgeon,Apollo Helath City,Hyderabad.

    
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