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"

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.