Bandages And Splints Flashcards by Cristin Juda

Functions of a bandage

Protection
Absorption of draining material
Compression of soft tissues
Stabilization/external coaptation

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External coaptation

Splint or cast used as primary stabilization technique for fracture management or support surgical repair, joint instability

Forms: temporary, primary, secondary

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Indications for external coaptation as primary fracture repair

Incomplete fracture in young animal
Simple fracture with minimal displacement
Ulna or fibula intact
Can stabilize joint above + below fracture
Financial constraint of owner

Below knee or above elbow

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Contraindications for external coaptation as primary fracture management

Joint fractures
Inability of split to counteract fracture forces
Joint cannot be stabilized above/below fracture

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Process for closed fracture reduction

Radiographs
Sedation/anesthesia
Limb alignment/fragment apposition
Appropriate bandage/split
Assess reduction by radiograph

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Requirements for radiographs of fracture

2 orthogonal views
Visualize joint above and below fracture

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Purpose of sedation/anesthesia

Reduce pain

Keep patient still while splinting

Muscle relaxation to assist manipulation

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Alignment

Orientation of bone with respect to normal anatomic axis (in all planes)

position of joint above/below fracture

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Reduction

Act of placing fracture fragments into apposition

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Apposition

Assessment of how fracture fragments relate to one another (how well fit together)

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Fracture reduction + alignment

Distract and manipulate fracture ends (90 deg hinge, then slowly straighten to fatigue muscles - working against muscle contraction)

Interdigitate ends

Goal: 100% apposition; 50% in 2 views is acceptable

Contraindications: bone starts to splinter or break

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Factors for selecting bandage material

Extent of soft tissue damage
Wounds
Type of weight bearing / joint mobility needed
Available materials
Size of patient
Temperament

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Bandage layer

Contact (primary) layer
Intermediate (secondary) layer - absorb fluid, support, compression
Outer (tertiary) layer - protect from environment, hold in place

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Tape stirrups

Used to prevent bandage from slipping off

Stick side of tape on dry limb
- medial/lateral or dorsal palmar
- extend 25-50% of bandage
- extra at end to turn up

Not always needed

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Application of cast padding / cotton

Start distally —> move up
Start with 100% overlap at toes
Overlap each layer by 50% up limb
Not too tight - will tear

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Kling gauze layer of bandage

Start distally —> move up

Snug, but not too tight

Always placed over appropriate amount of cotton

Holds splint

Outer vet wrap/tape

Not directly on hair or skin
Should not be needed to keep bandage from slipping
Loosely placed

Robert-Jones Bandage

Bulky compression bandage
Temporary support
Decrease swelling

Modified Robert-Jones bandage

Less cast padding, but enough to suppor / prevent rubbing of splint material

Compression bandage

Masson metal or plastic splints

Use with modified Robert Jones

Indications: digit, metacarpal, metatarsal injuries

“Spoon” under foot —> partial weight bearing

Aluminum rod splits

Use with modified Robert Jones
Form aluminum rod to shape of leg
Lateral splint or walking bar (weight bearing rod)
Varied thickness

Orthoplast splits

Plastic-y material; shaped when placed in hot water

Strong
Can cut to size
More expensive than fiberglass
Can be reshaped

Use with modified Robert Jones

Full cast

Rarely used in vet med

Cast materials

Fiber glass : light weight, strong, can be used to make splints

Cast application

Sedation/anesthesia Stirrups Primary layer (sometimes stockinet) Cast padding Kling gauze Turn stirrups up Apply cast (wet material, squeeze out excess water, 50% overlap)

Layers of cast material

Small dogs - at least 2 Large dogs - at least 4-6

Bivalve cast modification

Full cast cut in half Allows for swelling/changes to visualize skin/wounds Not as strong

Half cast/split

Use of cast material as a splinting device Most common use of cast material

Spica split

Splint to immobilize shoulder / hip joint Modified Robert Jones encircling torso under split Split: aluminum rod, orthoplst, casting material

Schroeder-Thomas splint

Not really used, difficult to keep from moving Traction splint for minimally displaced fracture

Velpeau sling

Maintains carpus, elbow, shoulder in flexion Non-weight bearing Indications: shoulder luxation / fracture

Elmer sling

Used for craniodorsal hip luxation Non-weight bearing Internally rotates hip + abducts limb 1-2 wk

Carpal flexion bandage

Used after flexor tendon repair Relieves tension from flexor tendons, non-weight bearing Caution: don’t leave too long or permanent contracture

Hobbles

Used for caudal ventral hip luxation Prevents abduction Weight bearing

Complications associated with bandaging

Pyderma, deep infections Skin abrasions Loss of bone density Loss of ROM Muscle contracture Ligament laxity Loss of cartilage

At home instructions

Monitor toes Monitor for slipping Pain Avoid becoming wet/soiled Recheck weekly E-collar!!!