Casting of upper limb

1. General introduction to nonoperative fracture care

Klaus Dresing and Jos Engelen are presenting a live interactive Webcast.

Learning goals

  • Describe the characteristics of the different casting materials.
  • Explain the principles of cast application.
  • Define the basic steps of post application treatment.
  • Recognize potential for and prevent complications.
  • Apply casts and splints and prescribe orthoses.

2. Videos from "Casts, Splints, and Support Bandages—Nonoperative Treatment and Perioperative Protection"

Introduction

The below videos are taken from the AO Publication "Casts, Splints, and Support Bandages - Nonoperative treatment and perioperative protection" edited by Klaus Dresing, Peter Trafton, and Jos Engelen. This publication examines the principles, methods, and techniques for applying a modern plaster or synthetic cast for the treatment of fractures, ligament, nerve, and soft-tissue injuries, overload injuries, and infections. It includes access to 55 cast and splint demonstrations on high-quality online video.

The book can be purchased both as a hard copy and as an E-Book

Casting book

Clavicle support bandage

Support bandage

Indications

  • Fracture of the clavicle

Goal

  • Stabilization of the forearm and elbow

Gilchrist bandage

Support bandage

Indications

  • Fracture of the proximal humerus
  • Shoulder injuries

Goal

  • Stabilization of the proximal humerus and the shoulder

Collar and cuff bandage

Support bandage

Indications

  • Fracture of the supracondylar humerus in children
  • Temporary immobilization in proximal diaphyseal humeral fractures and shoulder injuries in adults

Goal

  • Elbow in flexion to maintain position, depending on the extent of swelling

Elbow bandage

Support bandage

Indications

  • Strain
  • Sprain

Goal

  • Stabilization and pain relief

Sarmiento humeral brace

Synthetic, combicast technique

Indications

  • Diaphyseal fractures of the humerus
  • Not recommended for primary fracture care

Goal

  • Stabilization of the humeral shaft

Long arm splint

Plaster of Paris

Indications

  • Fracture of the forearm
  • Fracture of the radial head
  • Fracture of the distal humerus
  • Fracture of the epicondyle
  • Epicondylitis

Goal

  • Stabilization of the forearm and elbow
Synthetic

Indications

  • Fracture of the forearm
  • Fracture of the radial head
  • Fracture of the distal humerus
  • Fracture of the epicondyle
  • Epicondylitis

Goal

  • Stabilization of the forearm and elbow

Long arm cast

Plaster of Paris

Indications

  • Fracture of the radius
  • Fracture of the ulna
  • Fracture of the elbow
  • Epicondylitis

Goal

  • Stabilization of the forearm and elbow
Synthetic, combicast technique

Indications

  • Fracture of the radius
  • Fracture of the ulna
  • Fracture of the elbow
  • Epicondylitis

Goal

  • Stabilization of the forearm and elbow

Dorsopalmar (radial) short arm splint

Plaster of Paris

Indications

  • Fracture of the distal radius

Goal

  • Stabilization of the dorsal forearm and wrist
Synthetic

Indications

  • Fracture of the distal radius

Goal

  • Stabilization of the dorsal forearm and wrist

Palmar short arm splint

Plaster of Paris

Indications

  • Stable nondisplaced fractures of the distal radius
  • Radial nerve palsy

Goal

  • Stabilization of the fingers and/or metacarpus
Synthetic

Indications

  • Stable nondisplaced fractures of the distal radius
  • Radial nerve palsy

Goal

  • Stabilization of the fingers and/or metacarpus

Short arm cast

Plaster of Paris

Indications

  • Fracture of the distal radius

Goal

  • Stabilization of the distal forearm and wrist
Synthetic combicast technique

Indications

  • Fracture of the distal radius

Goal

  • Stabilization of the distal forearm and wrist

Wrist bandage

Support bandage

Indications

  • Strain
  • Sprain

Goal

  • Stabilization and pain relief

Thumb spica splint

Plaster of Paris

Indications

  • Fracture of the first metacarpal
  • Fracture of the scaphoid

Goal

  • Stabilization of first finger ray
Synthetic

Indications

  • Fracture of the first metacarpal
  • Fracture of the scaphoid

Goal

  • Stabilization of first finger ray

Short arm cast

Plaster of Paris with traction and reduction

Indications

  • Displaced fracture of the distal radius

Goal

  • Stabilization of the wrist

Short arm scaphoid cast

Synthetic

Indications

  • Fracture of first metacarpal
  • Fracture of the scaphoid

Goal

  • Stabilization of the carpal bones and the first finger ray

Dorsopalmar (ulnar gutter) short arm splint including two or more fingers

Plaster of Paris

Indications

  • Fracture of the proximal phalanges II–V
  • Fracture of the metacarpals II–V

Goal

  • Stabilization of the fingers and/or metacarpus
Synthetic

Indications

  • Fracture of the proximal phalanges II–V
  • Fracture of the metacarpals II–V

Goal

  • Stabilization of the fingers and/or metacarpus

Palmar short arm splint including the fingers

Plaster of Paris

Indications

  • Fracture of the proximal phalanges II–V
  • Fracture of the metacarpals II–V

Goal

  • Stabilization of the fingers and/or metacarpus

Short arm cast including two or more fingers

Synthetic, combicast technique

Indications

  • Fracture of the proximal phalanges II–V
  • Fracture of the metacarpals II–V

Goal

  • Stabilization of the fingers and/or the metacarpus

Kleinert dynamic splint

Plaster of Paris

Indications

  • Lesion of a flexor tendon

Goal

  • Postoperative functional treatment of a flexor tendon lesion
Synthetic, combicast technique

Indications

  • Lesion of a flexor tendon

Goal

  • Postoperative functional treatment of a flexor tendon lesion

Metacarpal glove

Synthetic, combicast technique

Indications

  • Nondisplaced or reducible fractures of the fifth metacarpal head
  • Also applicable for fractures of the metacarpal heads II–IV in a modified design

Goal

  • Stabilization of the metacarpal heads

Removable thumb orthosis

Synthetic

Indications

  • Ligamentous rupture of the first metacarpophalangeal joint

Goal

  • Stabilization of the first metacarpophalangeal joint

Removable finger splint

Synthetic

Indications

  • Fracture of the intermediate phalanx or ligamentous rupture of the proximal interphalangeal joint

Goal

  • Stabilization of the proximal interphalangeal joint

Mallet finger splint

Synthetic

Indications

  • Extensor tendon injury at the distal interphalangeal joint (mallet or baseball finger)

Goal

  • Full extension of the distal interphalangeal joint

3. Webinar

Casting in Children - Indications and Techniques

Theddy Slongo is presenting an interactive webinar about casting in children discussing indications and techniques.

Learning objectives:

  • Identify those fractures which are suitable for conservative treatment.
  • Explain the main biomechanical principles of cast fixation.
  • Recognize the difference between conventional plaster of Paris and fiber casting tape.
  • Describe the steps of correct casting techniques for the most frequent indications.
  • Anticipate the major risks and complications of casting.