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
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CASTS
BRACES
TRACTION
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 • 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
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 Splint
v a half cast used to
temporarily
immobilize and
protect body parts

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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
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 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
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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

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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
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 Patient Education
Educate client on basic
signs of Compartment
syndrome :
§ Pain,
§ Pressure,
§ Paresthesia
§ Pulselessness,
§ Swelling
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Compartment Syndrome

Ø a condition where there is

increasing pressure within
a muscle compartment,
which eventually leads to
the death of muscle tissue

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 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.
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 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

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 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
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 Body Cast

▷ For affections of
lower thoracic and
upper lumbar
spine

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Rizzer’s Jacket Cast

▷ For severe
scoliosis

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Minerva Cast

▷ For affections
of cervical and
upper dorsal
spine

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 Shoulder Spica Cast
▷ For affection of upper portion of
humerus and shoulder joint

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Shoulder Spica Mold

▷ For affection of upper

portion of humerus and
shoulder joint with
infection, swelling &
open wound
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Single Hip Spica Cast

▷ For affections of
the hip and femur

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Single Hip Spica Mold

▷ For affections of the

hip and femur with
infection, swelling or
open wound

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1 ½ Hip Spica Cast

▷ For affections
of the hip and
femur

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 1 ½ Hip Spica Mold

▷ For affections of the hip and femur

with infection, swelling or open
wound

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Double Hip Spica Cast

▷ For affections of
the hip and
femur

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 Double Hip Spica Mold

▷ For affections of the hip and femur

with infection, swelling or open
wound

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Cylinder Cast

▷ For patellar
affections

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 Short Leg
Circular Cast

▷ For affections
of ankle,
tarsals and
metatarsals

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Short Leg Posterior Mold

▷ For affections of
ankle, tarsals &
metatarsals with
infection,
swelling or open
wound
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Brace Cast
▷ For affections of
distal 3rd of femur
and proximal 3rd
of tibia with callus
formation
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 Long Leg Circular Cast
▷ For affections of tibia and fibula

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Long Leg Posterior Mold
▷ For affections
of tibia, fibula
with infection,
swelling or
open wound

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Patellar Tendon Bearing Cast

▷ For affections
of tibia –
fibula with
callus
formation
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 Quadrilateral Cast
( Ischial Weight Bearing Cast )
▷ For affections
of hip and
femur with
callus
formation
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 Delvit Cast
▷ For affections of
distal 3rd tibia-
fibula with callus
formation to allow
foot exercises
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 Basket Cast

▷ For massive or
severe bone
injuries of tibia

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Pantalon Cast

▷ For affections
of the pelvis

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 Frog Cast

▷ For congenital
hip dislocation

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Short Arm Circular Cast

▷ For affections
of the wrist,
carpals &
metacarpals

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Short Arm Posterior Mold

▷ For affections of
the wrist, carpals
& metacarpals
with infection,
swelling and
open wound
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 Long Arm
Circular Cast

▷ For affections
of radius and
ulna

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Long Arm Posterior Mold

▷ For affections of
radius and ulna
with infection,
swelling or open
wound
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 Munster Cast ( Fuenster Cast)
▷ For affections of radius and ulna
with callus formation

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Sugar Tong Cast

▷ For humerus
swelling,
infection and
inflammation

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Hanging Cast

▷ For
affections of
shaft of
humerus

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Functional Cast

▷ For affections of
the shaft of
humerus with
callus formation

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Airplane Cast ( Abductor Splint )
▷ For affections of the neck of the
humerus or for recurrent shoulder
dislocation

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Collar Cast

▷ For cervical
spine
affections

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 •a device used to
restrict or assist
BRACE body movement

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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

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Taylor Brace
▷ For affections
of upper
thoracic spine

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Jewette Brace

▷ For affections of
lower thoracic &
upper lumbar
spine

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Chair Back Brace

▷ For affections
of lumbosacral
spine

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Banjo Splint

▷ For peripheral
nerve injuries

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Bilateral Long Leg Brace

▷ For post-
poliomyelitis with
residual paralysis

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Dennis Browne Splint

▷ For clubfoot

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Cock-up Splint

▷ For wrist drop

deformity

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Roger Anderson External Fixator

▷ For comminuted
fracture

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Tower’s External Fixation

▷ For fracture of the

mandible

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Four Poster Brace

▷ For cervical and

upper thoracic
spine affection

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SOMI ( Sterno Occipito Mandibular
Immobilizer) Brace

▷ For cervical spine

affection

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 • The act of pulling or
drawing which is
associated with
TRACTION counter traction.

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 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)

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 Dunlop Traction
▷ Supracondylar
affection of the
humerus

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Buck’s Extension
Traction

▷ For hip and

femur affection

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 Modified Buck’s Extension
▷ For hip and femur affection

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 Bryant’s Traction
▷ For congenital hip
dysplasia
▷ For fracture of hip

and femur among

children 6 years old
and below
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 Head Halter
Traction

▷ For cervical
affection of the
spine

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 Pelvic Girdle

▷ For lumbar spine

affection
▷ For Herniated

Nucleus Pulposus

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Cotrel Traction

▷ Combination of
head-halter and
pelvic girdle
▷ For scoliosis

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 Hammock
Suspension

▷ For fracture
of the pelvis

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 Boot Cast
Traction

▷ For post-
poliomyelitis
with residual
paralysis

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 Halo - Pelvic
Traction

▷ For scoliosis

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Halo - Femoral
Traction

▷ For severe
scoliosis

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90 – 90 Degrees
Traction

For subtrochanteric
fracture of the femur

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 Zero Degree

▷ For affection of
neck of humerus
and shoulder
joints

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 Overhead
Skeletal
Traction

▷ For supracondylar
affectation of the
humerus

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Stove in Chest
Traction

▷ For multiple rib

fracture

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Balanced Skeletal Traction

▷ For hip and

femur
affectation

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