Source: Osteoarthritis Prevention
Author: Department of Orthopedics, Xiangya Hospital, Central South University, Xu Bei, Xiong Yilin
On snowy days, the road is slippery, and when the elderly accidentally fall, they will subconsciously support the ground with their hands, and after getting up, they will find that their wrists are painful, deformed, and unable to move. After being sent to the hospital for filming, the doctor said: "Old man, you have a fracture here, don't worry, give you a manual reset, and then a plaster cast will be fine." How exactly does this "plaster cast" treat fractures? Today, let's get to know the magical "plaster".
What is "plaster plastering"?
First of all, we often say that the traditional "gypsum" is a fine powder of anhydrous calcium sulfate (CaSO4) scattered on a special fine-pore gauze bandage, which is hardened and shaped in a short period of time after soaking in water, with strong shaping ability and good stability. The new polymer "gypsum" currently used is made of glass fiber polymer or polyester fiber polymer, which has the characteristics of high strength, light weight, thin thickness, breathable, waterproof, not easy to cause skin allergies, and can also pass X-rays. This "plaster" is not very magical!
The "plaster cast" refers to the form of fixation other than the plaster, so that the limbs are fixed for a long time, the limbs remain in a specific position, prevent the movement of the affected limbs, avoid fracture displacement, make the joints and soft tissues rest, and also enable the affected part to avoid re-injury.
▲ "Plaster Cast"
What situations do you need to "cast"?
In these cases a plaster cast is required:
Fixation of fractures;
Fixation of sprains of joints;
Joint dislocation after reduction;
Osteoarthritis in the case of acute and chronic inflammation;
Fixation after orthopedic surgery such as bones, joints and tendons;
Treatment after joint contractures or nerve paralysis;
Fixation of limbs after plasty surgery (eg, vascular suture, flap grafting);
Post-external fixation after orthopedic treatment of congenital or acquired malformations (eg congenital hip dysplasia);
"Plastering" is a basic skill of orthopedic surgeons, but it also requires a good grasp of the type of disease, the basic reduction method, the fixed position, the use of padding, the type, length and thickness of the plaster, etc., in order to play a plaster with "magical effect".
What should I pay attention to after the plaster cast?
1, the first few days, swelling, pain, what to do?
Elevation of the affected limb: It is best to raise the ends of the cast limb to or above the cardiac level, which facilitates venous return and promotes swelling and resolution.
Ice packs: Ice packs can be effective in controlling swelling, and ice packs can be used in areas where there is no cast but only bandages. Generally, it is iced for about 20 minutes, every 1-2 hours.
Exercise: There is no fixed part, moderately strengthen the activity exercise, through the muscle contraction activity to promote the return of venous blood to achieve the effect of swelling.
▲Elevate the affected limb
2. What if I really want to take a bath after playing plaster?
The strength of the cast will decrease significantly when exposed to water, and the dampness of the gypsum may also cause itching, odor, and local infection. So what if you really want to take a bath after a plaster cast? Is there any good way to take a shower on this hot day?
In 2014, Professor Mitch McDowell's team published an article in JBJS titled "A Comparative Study of the Various Methods of Keeping the Plaster Dry", which mentioned that while it is the wisest choice to keep the plaster as untouched as much as possible, if it must be wet, double-layer plastic bags bundled with strong tape and CVS professional plaster cases are the best choices for protecting the plaster!
▲Double plastic bag with strong tape tied tightly, tape
Only do a circular tightening on the outermost layer
▲ CVS professional plaster protective sleeve
3. After the plaster is applied, how long can it be removed?
Generally, the gypsum fixation time is about 6-8 weeks, but the specific duration varies from person to person and purpose, and it is necessary to review the X-ray regularly to determine. For example, younger patients have strong healing and repair ability, so the cast removal time may be relatively early. However, for older patients with poor nutritional status, the removal time may also be prolonged.
4. If it is abnormal, seek medical treatment in time
Finally, if the limb fixed by the cast has severe pain and numbness, the skin of the extremities becomes cooler, the color is bruised, etc., it is necessary to immediately seek medical attention to release the cast, so as to avoid the irreversible damage to the neuromuscular caused by excessive swelling and ischemia of the limb.
bibliography:
1. "Gypsum Fixation Technique" - Cao Yanlin
2. "Plaster cast want to take a bath? How to keep the plaster dry" - Lu Yao
3. Mcdowell, Mitch, S. Nguyen , and J.Schlechter. "A Comparison of Various Contemporary Methods to Prevent aWet Cast." JBJS 96(2014).
4. None. "Casts, Splints, and Support Bandages – Nonoperative Treatment and Perioperative Protection." Handchirurgie · Mikrochirurgie · Plastische Chirurgie 49.01(2017):66-66.
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The article is for reference and learning sharing only, and everything depends on the patient's own situation and the diagnosis and treatment of professional doctors.