Principles of casting and splinting. 2009

Anne S Boyd, and Holly J Benjamin, and Chad Asplund
University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

The ability to properly apply casts and splints is a technical skill easily mastered with practice and an understanding of basic principles. The initial approach to casting and splinting requires a thorough assessment of the injured extremity for proper diagnosis. Once the need for immobilization is ascertained, casting and splinting start with application of stockinette, followed by padding. Splinting involves subsequent application of a noncircumferential support held in place by an elastic bandage. Splints are faster and easier to apply; allow for the natural swelling that occurs during the acute inflammatory phase of an injury; are easily removed for inspection of the injury site; and are often the preferred tool for immobilization in the acute care setting. Disadvantages of splinting include lack of patient compliance and increased motion at the injury site. Casting involves circumferential application of plaster or fiberglass. As such, casts provide superior immobilization, but they are more technically difficult to apply and less forgiving during the acute inflammatory stage; they also carry a higher risk of complications. Compartment syndrome, thermal injuries, pressure sores, skin infection and dermatitis, and joint stiffness are possible complications of splinting and casting. Patient education regarding swelling, signs of vascular compromise, and recommendations for follow-up is crucial after cast or splint application.

UI MeSH Term Description Entries
D007103 Immobilization The restriction of the MOVEMENT of whole or part of the body by physical means (RESTRAINT, PHYSICAL) or chemically by ANALGESIA, or the use of TRANQUILIZING AGENTS or NEUROMUSCULAR NONDEPOLARIZING AGENTS. It includes experimental protocols used to evaluate the physiologic effects of immobility. Hypokinesia, Experimental,Experimental Hypokinesia,Experimental Hypokinesias,Hypokinesias, Experimental
D002370 Casts, Surgical Dressings made of fiberglass, plastic, or bandage impregnated with plaster of paris used for immobilization of various parts of the body in cases of fractures, dislocations, and infected wounds. In comparison with plaster casts, casts made of fiberglass or plastic are lightweight, radiolucent, able to withstand moisture, and less rigid. Fiberglass Casts,Plaster Casts,Plastic Casts,Cast, Surgical,Surgical Cast,Surgical Casts,Cast, Fiberglass,Cast, Plaster,Cast, Plastic,Casts, Fiberglass,Casts, Plaster,Casts, Plastic,Fiberglass Cast,Plaster Cast,Plastic Cast
D005194 Family Practice A medical specialty concerned with the provision of continuing, comprehensive primary health care for the entire family. Family Practices,Practice, Family,Practices, Family
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001134 Arm Injuries General or unspecified injuries involving the UPPER ARM and the FOREARM. Injuries, Arm,Arm Injury,Injury, Arm
D001458 Bandages Material used for wrapping or binding any part of the body. Dressings,Bandage,Dressing
D013165 Splints Rigid or flexible appliances that are used to maintain a displaced or movable part in position, or to maintain the position of and protect an injured part. Dynamic Orthoses,Dynamic Splint,Dynamic Splinting,Dynamic Splints,Static Orthoses,Static Splint,Static Splinting,Static Splints,Dynamic Splintings,Splint,Splint, Dynamic,Splint, Static,Splinting, Dynamic,Splinting, Static,Splints, Dynamic,Splints, Static,Static Orthose

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