Casting Flashcards
What boney prominences do we want to avoid when casting
The fibular head
Do we want to cast at R2?
No, somewhere between R2 and R1 or r1
What should we keep in mind when casting a patient with their knee bent
That the stretch to their ankle will be stronger with knee straight
How long do we leave an initial cast on a patient
24 hours
When would we want to remove a cast from a patient
Severe agitation
What are the 4 indications for casting
correct deformity
lengthen muscles
reduce spasticity (not well supported)
Prevent loss of ROM
Casts used to increase PROM are most effective when?
When used in 1st 6 months with patients demonstrating ongoing neurological and functional recovery of limb
When using a cast to provide a prolonged passive stretch, we want the joint in a ________ range
submaximal range
_________ of stretching was shown to be necessary to affect sarcomere length
6 hours
How can a cast decrease sensory input to decrease primitive reflexes?
Shields from noxious/excitatory stimuli
Stimulation over 2nd, 3rd metacarpal head -> toe grasp reflex
stimulation of medial foot -> inversion
stimulation of lateral border of foot and 5th met head -> eversion
Stimulation on heel -> Dorsiflexion
How much was inhibitory casting shown to affect spasticity
Only make short term difference for about 3 days
Contraindications to casting:
Unhealed fx
poor skin
bony block/end feel
fluctuating edema
reduced sensation
agitation
impaired circulation
acute inflammation
What is a bivalve?
Used when serial casting is finished to maintain new ROM
Last serial cast is cut in half and held together with straps for easy donning and doffing
when making a bivalve, which half needs more material
Posterior half (because thats where the foot sits)
What part of the cast do we put the plaster on first?
the joint
How long can the subsequent cast be left on a pt
5-7 days
what does research say about shorter intervals of changing casts
fewer complications with comparable ROM gains
What are the 4 indications for castin
Correct deformity
Prevent loss of ROM at joint
Fx management
Reduce spasticity (not well supported)
What is an ankle knee cast used for?
for aggressive stretching of gastroc
