Musculoskeletal Care Modalities Flashcards
*A rigid, external immobilizing device
Uses
*Immobilize a reduced fracture
*Correct a deformity
*Apply uniform pressure to soft tissues
*Support and stabilize weakened joints
Materials:
*nonplaster(fiberglass)
*plaster of Paris
Cast
Types of Casts
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Extends from below the elbow to the palmar crease, secured around the base of the thumb. If the thumb is included, it is known as a thumb spica or gauntlet cast.
Short-arm cast:
Types of Casts
*Extends from the axillary fold to the proximal palmar crease. The elbow usually is immobilized at a right angle.
Long-arm cast
Types of Casts
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Extends from below the knee to the base of the toes.
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The foot is flexed at a right angle in a neutral position.
Short-leg cast
Types of Casts
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A short-or long-leg cast reinforced for strength.
Walking cast
Types of Casts
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Extends from the junction of the upper and middle third of the thigh to the base of the toes.
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Knee may be slightly flexed.
Long-leg cast
Types of Casts
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A body jacket that encloses the trunk, shoulder, and elbow.
Shoulder spica cast
Types of Casts
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Encircles the trunk.
Body cast
Types of Casts
Hip spica cast
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Encloses the trunk and a lower extremity.
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A double hip spica cast includes both legs.
*Less costly and achieve a better mold than fiberglass casts
*Not as durable and take longer to dry.
*Rolls of plaster of Paris-impregnated bandages are wet in cool water and applied smoothly to the body.
*Does not have its full strength until it is dry
Plaster Casts
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Composed of water-activated polyurethane materials that have the versatility of plaster
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Lighter
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Stronger
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more durable than plaster
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Water resistant (thorough drying is needed)
Fiberglass Casts
A dry plaster cast is white and shiny, resonant to percussion, odorless, and firm.
A dry plaster cast is white and shiny, resonant to percussion, odorless, and firm.
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Contoured splints of plaster or pliable thermoplastic materials may be used for:
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Conditions that do not require rigid immobilization
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For those in which swelling may be anticipated
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And for those who require special skin care
Splints
*Custom fitted to various parts of the body and are used to:
*Provide support
*Control movement
*And prevent additional injury
*Indicated for longer use than splints
Braces (i.e., orthoses)
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*Serious complication
*Occurs from increased pressure in a confined space
*Compromises blood flow
*Ischemia and irreversible damage can occur within hours
*6 Ps; pain - early indicator
*Treatment: Notify physician, cast may be removed, AND emergency fasciotomy may be necessary
Compartment syndrome:
*Caused by inappropriately applied cast
*Lower extremities most susceptible
*Patient reports painful “hotspot” and tightness
*Dx: May cut window in the cast for inspection and access
*Treatment: dressing applied over exposed skin
Pressure ulcer
*muscle atrophy and loss of strength
*Treatment: Isometric exercises, muscle setting exercises
Disuse Syndrome
*Used to manage open fractures with soft tissue damage
*Provide support for complicated or comminuted fractures
*Pt requires reassurance because of appearance of device
*Discomfort is usually minimal, and early mobility may be anticipated with these devices
*Elevate to reduce edema
*Monitor for s/s of complications
*Pin care
*Patient education
External Fixation Devices
*the application of pulling force to a part of the body
Purposes
*Reduce muscle spasms
*Reduce, align, and immobilize fractures
*Reduce deformity
*Increase space between opposing forces
*Used as a short-term intervention until other modalities are possible
Traction
*Used to treat severe joint pain and disability and for repair and mgt of joint fractures or joint necrosis
*Frequently replaced joints include the hip, knee, and fingers
*Joints including the shoulder, elbow, wrist, and ankle may also be replaced
Joint Replacements
Preventing Dislocation of Hip Prosthesis
*Correct positioning using splint, wedge, pillows
*Keep hip in abduction when turning, adduction when transferring
*Limited flexing of the hip; <90 degrees
Preventing Dislocation of Hip Prosthesis
*Correct positioning using splint, wedge, pillows
*Keep hip in abduction when turning, adduction when transferring
*Limited flexing of the hip; <90 degrees
