TYPES OF TRACTION - Long arm circular cast

1. Manual traction - Long arm posterior mold

2. Skeletal tractionx - Hanging cast
3. Skin traction - Sugar tong
Kirschners wire holder- affection of the radius, ulna; thinner - Shoulder spica cast
than steinmanns’s pin - Abduction splint/airplane cast
Steinmann’s pin holder- affection of the humerus, femur, tibia. - Thumb spica cast
Fibula - Functional cast
- Crutchfield tong - Munster cast
- BST Cast in the Lower Extremities
- Overhead traction - Short leg circular cast
- Ninety-ninety degrees traction - Short leg posterior mold
- Halo-pelvic traction - Long leg circular cast
- Halo-femoral traction - Long leg posterior mold
a. Adhesive- use of adhesive tape, elastic bandage, wooden - Cylinder cast
spreader and wadding sheet - Cylinder mold
- Dunlop traction - Delvitt cast
- Zero degree traction - Patellar tendon bearing cast
- Modified bucks traction - Quadrilateral/Ischial weight-bearing cast
- Bucks extension traction - Cast brace
- Bryant traction - Basket cast
- Boot cast traction - Single hip spica cast
b. Non-adhesive- use of canvas, straps with buckes, laces and - One and one half hip spica cast
ribbons
- Double hip spica cast
- head halter traction
- Pantalon cast
- pelvic girdle traction
- Frog cast
- hammock suspension traction
- Walking cast
- cotrel traction
Internal rotator board
CAST
Principles in the application: Night splint
1. apply padding first before applying cast. BRACE- a mechanical support for weakened muscles, joints and
2. Apply cast by including the joint below the affection. bones in rehabilitation.
3. Apply cast in circular motion and smooten with palm Functions:
4. Support with the palm. - For immobilization
https://www.youtube.com/watch?v=rPajAfGgyTU - To control involuntary movement
Materials: - For support
1. Stockinet - Permit patient’s to walk without fatigue
2. Wadding sheet and gauze bandage - Prevent and correct deformity
3. Plaster of Paris/fiber glass - Maintain body alignment
4. Trimming knife Different types of Braces:
5. Stryker cast cuttet - Shantz collar brace
Contraindications: - Philadelphia collar brace
1. Pregnancy - Four poster brace
2. Skin disease - Jewette brace
Complications - Knight taylor brace
1. Necrosis - Forester brace
2. Neurovascular compromise- monitor for movement, color, - Chair back brace
numbness, edema, sensation, warmth
- Banjo splint
3. Pressure sores
- Cock-up splint
4. Nerve palsies
- Oppen heimer
5. Incorrect fracture alignment
6. Cast syndrome- nausea. Abdominal pressure, feeling of - Yamamoto brace
tightness and bloating, inability to take deep breath - Milwaukee brace
CAST TECHNIQUES - Arm sling
1. Windowing.- putting a hole on a cast on the site of an open - Shoulder strap
wound of the casted extremity for the purpose of visualization, - Unilateral/bilateral long leg brace
inspection, dressing as well as application of medication. - Short leg brace
2. Bivalving- cutting the cast into 2 halves from the upper portion to - Dennis browne Shoes
the bottom part for the purpose of relieving possible cast - Brown bohler braun splint
tightness. - Live finger splint
3. Reinforcing- reapplication of plaster of paris for the purpose of - SOMI brave
regaining its strength in case of wetting the cast which resulted to - Atlanta brace
its instability. ORTHOPEDIC HARDWARES:
Cast of the trunk - Tower External fixators
- Collar cast - Roger Anderson External Fixator
- Body cast - Delta frame External Fixator
- Minerva cast - Hybrid External Fixator
- Rizzer’s jacket - Ilizarov External Fixator
Cast in the Upper Extremities - Spanning External Fixator
- Short arm circular cast - Hoffman’s External fixator
- Short arm posterior mold
 OTHERS: 1. There should be no knots near the pulley
- Compression hip screw fixator 2. Cords should be running along the grooves of the pulley
- Y bone plate 3. Weights should be hanging freely
- Buttress plate 4. Observe for the wear and tear of the bags and the cords.
- Intramedullary nail APPLICATION:
- Drill bit
1. Measure the distance from the lateralside of the trochanter to the knee by
- Antibiotic beads
- Spacer antibiotic using one of the cords.
- Austin moore hip prosthesis 2. Position the Pearson’s attachment under the Thomas splint according to
- Bipolar hip dislocation above measurement. Screw them together.
- Knee prosthesis
- Knee prosthesis
3. Apply the rest splint
- Tension bond 4. Apply the slings following the principles below:
- Cerclage wire a. Start from the medial aspect of the Thomas splint and fasten at the lateral
- Gigli saw
aspect with clips or pins to prevent injury
- Osteotome chisel
- Hemovack b. Apply slings snugly, not too tight (so as not to impede circulation) nor too
- Skin stapler loose (which defeats the purpose of support)
BST Procedural Checklist Discussion
c. The smooth surface of the slings should come in contact with the skin (to
- Traction is the act of pulling and drawing which is
associated with counter traction prevent skin irritation)
INDICATIONS: d. Provide approximatelyan inch space between the slings (for ventilation)
1. For immobilization
2. To prevent and correct deformity
e. If slings are too long, fanfold it
3. To maintain good alignment f. Number of slings willvarywith size of patient’s leg
4. To reduce pain and muscle spasm g. Keep the ankle and the popliteal area free from slings (these are highly
5. For support
6. To reduce fracture vascular areas)
h. The broader and longer slings are for the thigh area while the narrower
PREPARATION: and shorter ones are for the legarea.
1. Check the doctor’s order
a. Patient’s name
5. Using a slip knot, tie one end of the thigh rope at the
b. Extremity to be placed on BST
junction of the medial upright of the Thomas splint (for
c. Weights to be applied
privacy).
2. Prepare patient psychologically
6. Decide on the three manpower team
a. Introduce yourself
A. Insert the Thomas Spont and Pearson’s Attachment
b. Inform patient on what is to be done
without moving the leg inappropriately. (Position self
c. The purpose of the treatment
at far end of the foot of the bed on the affected side).
d. Expectation from the patient
B. Provide continuous manual traction and pushes
3. Prepare the bed and equipment needed
Braun bohler splint away from work area (position
a. Orthopedic bed
self in between the 1st and 3rd man)
Firm mattress
C. Support leg with palm on hand. (Position self atr the
Fracture board
side near the affected leg)
Bed elevator/ shock block (optional)
7. Instruct the patient on the following:
Balkan frame (cross bar, curve bar, vertical, horizontal, diagonal
A. Hold on the overhead trapeze
bars)
B. Flex the unaffected leg and lift the buttocks.
3 pulleys
C. At the count of three, swing the body so that we
3 clamps
simultaneously tranfer at the affected leg on the
Overhead trapeze
Thomas Splint.
a. Traction equipment
8. At the count of three, transfer the affected leg while
Thomas splint (with half ring)
providing manual traction.
Pearson’s attachment
9. Using a slip knot, tie one end of the traction cord at the
Rest splint
Steinmann’s pin holder. Pass the cord along the groove of
Steinmann’s pin holder
the third pulley, then attach the traction weight bag (10% of
Braun Bohler splint
the weight of the client) to the other end of the traction cord
Slings with clips or pins
using any kind of knot. There should be one foot distance
3 sash cords (thigh rope, traction rope, suspension rope)
from the pulley to the knot or the bottom part of the bag
2 weight bags
should be at the level of the bed. Consume the rope.
Traction weight (10% of pt’s body weight)
10. Tie the other end of the thigh cord to the lateral aspect of
Suspension weight (1/2 of traction weight)
the Thomas splint using a slip knot.
Foot pedal or foot board
11. Using again a slip knot, tie one end of the suspension cord
PRINCIPLES:
to the middle of the thigh cord; Pass the cord along the
1. Patient should be in dorsal recumbent position
groove of the first pulley, then to the suspension weight bag
2. There must be counter traction (patient’s weight serves as
(½ of the weight of the traction weight), temporarily hang
the counter traction)
the weight bag over the pulley. Then pass the same cord
3. There must be continuous traction
along the groove of the second pulley, down to the outer
4. The line of pull should be in line with the deformity (the first
side of the traction cord, then under the rest splint. Tie it
pulley is in line with the inguinal area, the second pulley is in
over the end of the Thomas splint using a clove-hitch knot
line with the knee, the third pulley is in line with the first and
and another clove hitch knot at the end of the Pearson’s
the second pulley)
attachment. Consume the rope.
5. Avoid friction
12. Release the suspension weight and remove the rest splint
 13. Apply foot pedal using ribbon knot. The shorter cords  Ulna
should be tied at the Thomas splint while the longer cords o Wrist or carpal bones
are tied to the Pearson’s attachment in between the last
 Scaphoid
and the second to the last sling.
14. Check for the efficiency of the traction by swinging
 Lunate
backwards and forward and sideways.  Triquetrum
 Pisiform
HOW TO REMOVE THE TRACTION  Trapezium
1. Hang the suspension weight.  Trapezoid
2. Apply the rest splint  Capitate
3. Apply the suspension cord and weight bag  Hamate
4. Apply manual traction and remove the traction weight. o Hand
5. Tie the traction rope instead to the rest splint then the
Thomas splint and to the Pearson’s attachment using the
 Metacarpals x5
clove-hitch knot.  Phalanx x14
b. Lower Limb
Topic Outline o Pelvic girdle (hip or coxal bone)
Unit 1. Recall the Anatomy of the Skeletal System  Ilium
Unit 2. Fracture  Ischium
a. Definition  Pubis
b. Causes of Fracture
c. Clinical manifestations of fracture o Thigh
d. Classifications of Fracture  Femur
e. Diagnostic Tests o Leg
f. Complications  Tibia
g. Nursing Diagnosis  Fibula
h. Nursing Management o Tarsal bones
Unit 3. Bone Healing Process
 Talas
a. Types of Bone Healing process
b. Factors affecting Bone Healing Process  Calcaneus 
c. Stages of Bone Healing Process  Cuboid
Unit 4. Management of Fracture  Medial, intermediate, and lateral cuneiform
a. Principles  Navicular
b. Different Types of the Management of Fracture o Foot
1. Traction, its types and indications  Metatarsals x5
2. Casts & Molds & its indications  Phalanx x14
3. Braces & Splints & Its indications
4. Fixators and its indications Unit 2. Fracture
Unit 5. Applications of BST DEFINITION
BST Procedural Checklist Discussion A fracture is a traumatic injury interrupting bone continuity.
It is a break in the continuity of bones

CONTENTS CAUSES OF FRACTURE

1. Injury
Unit 1. Recall the Anatomy of the Skeletal System  Direct or indirect Force or a crushing form
Human Skeleton 2. Twisting force
Total Number of Bones-206 3. Powerful muscle contraction
Divisions of the Skeletal System 4. Fatigue and stress
1. Axial Skeleton-80 Bones
a. Skull - 29
 Cranial Bones - 8
 Facial bones – 14
 Ear Ossicles – 6
 Hyoid Bone – 1
b. Ribs and Sternum - 25
 True Ribs – 7 pairs
 False Ribs – 5 pairs (2 pairs are Floating ribs)
 -Sternum – 1 5. Disease or tumor( Pathologic)
2. Appendicular skeleton- 126 bones (all bones exist in
pairs) 
a. Upper Limb
o Shoulder girdle
 Clavicle
 Scapula
o Arm
 Humerus CLINICAL MANIFESTATIONS OF FRACTURE
o Forearm  Pain
 Radius  Edema
  Tenderness
 Abnormal movement and crepitus
 Loss of function
 Ecchymoses
 Visible deformity
 Paresthesias and other sensory abnormalities

CLASSIFICATIONS OF FRACTURE
TYPES:
 Closed simple, uncomplicated fractures – do not
cause a break in the skin.
 Open compound, complicated fractures – involve
trauma to surrounding tissue and break in the skin.
 Incomplete fractures– are partial cross-sectional breaks
with incomplete bone disruption.
 Complete fractures – are complete cross-sectional
breaks severing the periosteum.
 Comminuted fractures – produce several breaks of the
bone, producing splinters and fragments.
 Greenstick fractures – break one side of a bone and
bend the other.
 Spiral (torsion) fractures – involve a fracture twisting
around the shaft of the bone.
 Transverse fractures – occur straight across the bone.
 Oblique fractures – occur at an angle across the bone
(less than a transverse)

image by : physio-pedia.com

DIAGNOSTIC TESTS
To determine the presence of fracture the following diagnostic
tools are used.

 X-ray examinations: Determines location and extent

of fractures/trauma, may reveal preexisting and yet
undiagnosed fracture(s).
 Bone scans, tomograms, computed tomography
(CT)/magnetic resonance imaging (MRI)
scans: Visualizes fractures, bleeding, and soft-tissue
damage; differentiates between stress/trauma
fractures and bone neoplasms.
 Arteriograms: May be done when occult vascular
damage is suspected.
 Complete blood count (CBC): Hematocrit (Hct) may
be increased (hemoconcentration) or decreased
(signifying hemorrhage at the fracture site or at
distant organs in multiple trauma). Increased white
blood cell (WBC) count is a normal stress response
after trauma.
 Urine creatinine (Cr) clearance: Muscle trauma
increases the load of Cr for renal clearance.
 Coagulation profile: Alterations may occur because
of blood loss, multiple transfusions, or liver injury.

COMPLICATIONS
  Inadequate immobilization
 Space or tissue between bone fragments
 Infection
 Local malignancy
 Metabolic bone disease (Paget’s disease)
 Irradiated bone (radiation necrosis)
 Avascular necrosis
 Intra-articular fracture (synovial fluid contains fibrolysins,
which lyse the initial clot and retard clot formation)
 Age (elderly persons heal more slowly)
NURSING DIAGNOSIS  Corticosteroids (inhibit the repair rate)

 Pain related to fracture, soft tissue damage, muscle BONE HEALING PROCESS
spasm, and surgery
 Impaired physical mobility related to fractured hip d. Types of Bone Healing process
 Impaired skin integrity related to surgical incision
 Risk for impaired urinary elimination related to immobility
 Risk for disturbed thought process related to age, stress
of trauma, unfamiliar surroundings, and drug therapy
 Risk for ineffective coping related to injury, anticipated
surgery, and dependence
 Risk for impaired home maintenance related to fractured
hip and impaired mobility

NURSING MANAGEMENT
1. Prevent infection
 Cover any breaks in the skin with clean or sterile
dressing.
2. Provide care during client transfer.
 Immobilize a fractured extremity with splint in the position
of the deformity before moving the client; avoid
strengthening the injured body part if a joint is involved.
 Support the affected body part above and below fracture
site when moving the client.
3. Provide client and family teaching. e. Factors affecting Bone Healing Process
 Explain prescribed activity restrictions and necessary
lifestyle modification because of impaired mobility.
 Teach the proper use of assistive devices, as indicated.
4. Administer prescribed medications, which may
include opioid or nonopioid analgesics and
prophylactic antibiotics for an open fracture. f.
5. Prevent and manage potential complications. f.
 Observe for symptoms of life-threatening fat embolus, f.
which may include personality change, restlessness,
dyspnea, crackles, white sputum, and petechaie over the
chest and buccal membranes. Assist with respiratory
support, which must be instituted early.
 Observe for symptoms of compartment syndrome, which
include deep, unrelenting pain; hard edematous muscle;
and decreased tissue perfusion with impaired
neurovascular assessment findings.
 Monitor closely for signs and symptoms of other
complications.
6. Patient education regarding different factors that
affect fracture healing f. Stages of Bone Healing Process
Factors that enhance fracture healing Formation of Hematoma
 Immobilization of fracture fragments Cellular Proliferation
 Maximum bone fragment contact Callus Formation
 Sufficient blood supply Ossification
 Proper nutrition Remodeling
 Exercise: weight bearing for long bones
 Hormones: growth hormone, thyroid, calcitonin, vitamin D,
anabolic steroids

Factors that inhibit fracture healing

 Extensive local trauma
 Bone loss
 INDICATIONS

OPEN REDUCTION

- It is performed through surgical intervention. Open

reduction internal fixation (ORIF) is a surgical approach
MANAGEMENT OF FRACTURE
that's used for repairing certain types of bone fractures.
- An open reduction is an invasive surgical bone
realignment. Internal fixation is the surgical insertion of
hardware to stabilize and hold the bone in place as it
heals.

Recovery will depend on several factors:

1. severity of the injury
2. type of bone involved
3. post-operative rehabilitation
4. age
Management of Fractures and its Principles 5. health condition

INDICATIONS
a. breaks in multiple places
b. moves out of position
c. sticks out through the skin

Internal fixation is an operation in orthopedics that involves

the surgical implementation of implants for the purpose of
repairing a bone, a concept that dates to the mid-nineteenth
century and was made applicable for routine treatment in the
mid-twentieth century. An internal fixator may be made
of stainless steel, titanium alloy, or cobalt-chrome alloy or
plastics.
Types of internal fixators include:
 Plate and screws
 Kirschner wires
 Intramedullary nails
 Tension band wires

Internal fixation devices include metal plates and screws,

stainless steel pins (Kirschner wires, K-wires), and stabilizing
rods that are placed into the cavity of the bone (intramedullary
nails, IM nails).

A cast is placed after surgery. Different types of casts may be

used during the healing process
Kirschner or K Wires Are Surgical Bone Pins
Kirschner Wires
K-wires come in different sizes, and as they increase in size,
they become less flexible. Some K-wires are threaded
Uses
1. to stabilize a broken bone and can be removed in the
office once the fracture has healed. 
2. helps prevent movement or backing out of the wire,
although that can also make them more difficult to remove.
3. to provide a rigid anchor to the bone, and then the weight
is pulled on the bone (through the wire) to pull the broken
extremity into alignment when used in traction

There are possible complications associated with the use

of K-wires:
 Infection: The location of pin insertion can be a source for
infection to enter the body.If left through the skin, bacteria
can travel along the pin tract and get deeper into the body,
and possibly to the bone. For this reason, patients with K-
wires that are left exposed are typically instructed on
techniques for pin care to prevent infection.
 Breakage: Pins can provide stable fixation of a fracture,
but most pins are relatively thin in diameter and they can
break if there is increased stress on the broken bone.
 Fracture movement: K-wires generally provide less rigid
fixation of fractures than some other techniques such as
plates and screws, and metal rods. It is sometimes
possible for the fracture to shift its position when only K-
wires are used for fixation.3 Therefore, K-wires are
generally used only for certain types of fractures.
 Migration: One of the most concerning complications is
pin migration. For this reason, extreme care must be used
especially when using K-wires in the chest or
abdomen. Although rare, there are case reports of placing
K-wires in bones around the shoulder that were found to
migrate to the chest cavity weeks or months later.

Tension Band Wiring Application

Angled Plates

EXTERNAL FIXATORS

SCREWS

Gliding screw Locking Screw

Example: RAEF
UNiVERSAL MINI EX TERNAL FIXATOR

Hybrid External Fixator

 CAST
A cast holds a broken bone in place as it heals. Casts also help TYPES OF CAST, MOLDS AND INDICATIONS
prevent or decrease muscle contractions, and are effective at 1. AIRPLANE CAST – for humerus and shoulder joint with
providing immobilization, especially after surgery. Casts compound fracture.
immobilize the joint above and the joint below the area that is 2. BASKET CAST – for severe leg trauma with open wound or
to be kept straight and without motion. For example, a child inflammation.
3. BODY CAST – for lower dorso-lumbar spine affectation.
with a forearm fracture will have a long arm cast to immobilize
4. BOOT LEG CAST – for hip and femoral fracture.
the wrist and elbow joints. The outside, or hard part of the cast,
5. CAST BRACE – for fracture of femur (distal curve) with flexion
is made from two different kinds of casting materials. and extension.
 Plaster (white in color) 6. COLLAR CAST – for cervical affectation.
 Fiberglass (comes in a variety of colors, patterns, and designs) 7. CYLINDRICAL LEG CAST – for fractured patella.
 Stockinette 8. DELVIT CAST – for fracture of tibia or fibula with callus
 Rolled cotton Pads formation
9. DOUBLE HIP SPICA CAST – for fracture of hip and femur.
 Cast Scissor 10. DOUBLE HIP SPICA MOLD – cervical affectation with callus
Cast is a temporary immobilization. Its types are (a) plaster and formation.
(b) fiber glass. 11. FROG CAST – for congenital hip dislocation.
Function: 12. FUNCTIONAL CAST – for fractured humerus with abduction
1. To promote healing and early weight bearing. and adduction.
2. To support, maintain and protect realigned bone. 13. HANGING CAST – for fractured shaft of the humerus.
3. To prevent or correct deformity 14. INTERNAL ROTATOR SPLINT – for post hip operation.
4. To immobilize 15. LONG ARM CIRCULAR CAST – for fractured radius or ulna
16. LONG ARM POSTERIOR MOLD – for fractured radius or
ulna with compound affectation.
17. LONG LEG CIRCULAR CAST – for fractured tibia-fibula.
Nursing care 18. LONG LEG POSTERIOR MOLD – for fracture tibia-fibula
 Keep the cast clean and dry. with compound affectation.
 Check for cracks or breaks in the cast. 19. MINERVA CAST – for upper dorsal or cervical affectation.
 Pad rough edges to protect the skin from scratches. 20. MUNSTER CAST – for fractured radius or ulna with callus
 Don't scratch the skin under the cast by putting objects inside formation.
the cast. 21. NIGHT SPLINT – for post polio.
22. PANTALON CAST – for pelvic bone fracture
 Use a hairdryer placed on a cool setting to blow air under the
23. PATELLA TENDON BEARING CAST – for fractured tibia-
cast and cool down the hot, itchy skin. Never blow warm or hot
fibula with callus formation.
air into the cast.
24. QUADRILATERAL (ISCHIAL WEIGHT BEARING) CAST –
 Don't put powders or lotion inside the cast. for shaft of femur with callus formation.
 Cover the cast while your child is eating to prevent food spills 25. RIZZER’S JACKET – for scoliosis
and crumbs from entering the cast. 26. SHORT ARM CIRCULAR CAST – for wrist and fingers.
 Prevent small toys or objects from being put inside the cast. 27. SHORT ARM POSTERIOR MOLD – for wrist and fingers
 Raise the cast above heart level to decrease swelling. with compound affectation.
 Encourage your child to move his or her fingers or toes to 28. SHORT LEG CIRCULAR CAST – for ankle and foot fracture.
29. SHORT LEG POSTERIOR MOLD – for ankle and foot with
promote circulation.
compound affectation.
 Don't use the abduction bar on the cast to lift or carry the child. 30. SHOULDER SPICA – for humerus and shoulder joint.
Older children with body casts may need to use a bedpan or 31. SINGLE HIP SPICA – for hip and 1 femur.
urinal to go to the bathroom. Tips to keep body casts clean and 32. SINGLE HIP SPICA MOLD – for pelvic fracture with callus
dry and prevent skin irritation around the genital area include formation.
the following: 33. 1 AND ½ HIP SPICA – for hip and femur.
 Use a diaper or sanitary napkin around the genital area to 34. 1 AND ½ SPICA MOLD – for hip and femur with compound
prevent leakage or splashing of urine. affectation.
 Place toilet paper inside the bedpan to prevent urine from
splashing onto the cast or bed. CASTS
 Keep the genital area as clean and dry as possible to prevent
skin irritation. COLLAR CAST
Note for the following manifestations when patient is in cast to affection of the cervical spine
report to the physicians
 Fever (see Fever and children, below)
 Chills
 Increased pain
 Increased swelling above or below the cast
 Decreased ability to move toes or fingers BODY CAST
 Complaints of numbness or tingling -affection of the dorso-lumbar
 Drainage or bad odor from the cast spine
 Cool or cold fingers or toes
 The cast becomes wet or dirty
 Blister, sores, or a rash develop under the cast
MINERVA CAST -affection of the upper portion of the humerus and
shoulder joint with infection, open wound and swelling
Scoliosis

HANGING CAST
-affection of the shaft of the
humerus
RIZZER’S JACKET

-Severe scoliosis

LONG LEG CIRCULAR CAST

SHORT ARM CIRCULAR CAST - fracture tibia fibula
-affection of the wrist and fingers SHORT LEG CIRCULAR CAST
LONG ARM CIRCULAR CAST - affection of the ankle and legs
-affection of the radius and ulna

LONG LEG POSTERIOR MOLD

LONG ARM POSTERIOR
- affections of the tibia fibula with
MOLD infection, open wounds.
-affections on radius ulna with
SHORT LEG POSTERIOR MOLD
infection, open wound and swelling. - affections of the ankle and toes with
SHORT ARM POSTERIOR MOLD
infections and open wounds
-affections of the wrist and fingers
with infections and open wounds

SINGLE HIP SPICA CAST

-Affection of the 1 hip and 1
MUNSTER CAST
femur
-affection of the radius ulna
with callus formation allows extension
and flexion of the elbow.

1 ½ HIP SPICA CAST

-Affection of the hip and femur
SHOULDER SPICA CAST
-affection of the upper portion of the
humerus and shoulder joint

Airplane Cast- affection of the upper DOUBLE HIP SPICA CAST

shaft of the humerus and shoulder
joint with compound fracture
bilateral affection of the hip and
FUNCTIONAL CAST femur
affection of the shaft with callus
formation. Allow flexion and extension
of the upper extremity.

QUADRILATERAL CAST
SHOULDER SPICA
POSTERIOR
MOLD/SUGAR TONG - Or ischial weight bearing cast
-fx of the shaft of femur with callus formation

DELVIT CAST
–affection of the proximal tibia fibula and allow flexion and
extension of the knee.

For scoliosis Boston Brace- For scoliosis

BASKET CAST -to immobilize foot, knee and ankle while

allowing wound for exposure.

BRACE CAST
-affection of the end of femur and allows
gradual flexion of the knee

FROG CAST
-Congenital hip dislocation

CYLINDER CAST
-fx of patella

CYLINDER POSTERIOR MOLD

-affection of the patella infection, open
wound and swelling

PANTALON CAST
-affection of the pelvis

PATELLAR TENDON
BEARING CAST
-ex. Shaft tibia fibula with callus
formation

BRACES AND SPLINTS

Knight Taylor Brace Chairback Brace-

 Lumbosacral affection

CDH- Congenital Dysplasia of the Hip or Congental Hip

dislocation or Congenital hip dysplasia
CTEV- Congetal equine varus

For CervicoThoracLumbar Spine affection

LUMBOSCRAL Affection For Pott’s Disease( Thoracic)

CERVICO THORACIC ORTHOSIS

Spinal Orthosis Brace-Scoliosis

For Cervical spine affection

For Cervical spine affection

A Jewett brace is a
hyperextension brace that
prevents the patient from
bending forward too much. It is often used to facilitate healing Skeletal Traction - Skeletal traction is used for fractures of the
of an anterior femur (thighbone), pelvis, hip, and certain upper arm fractures.
wedge compression fracture involving the T10 to L3 vertebrae. It involves inserting a pin or wire directly into the bone, then
Corset brace attaching weights through pulleys or ropes to it that control the
A corset brace is similar to a traditional corset. It typically has amount of pressure applied. Skeletal traction is used for
metal or plastic stays to limit forward movement. It puts fractures that require a high amount of force applied directly to
the bone, as it allows more weight to be added with less risk of
pressure over the belly to take pressure off of the spine and
damaging the surrounding soft tissues. If you need skeletal
promote healing. traction, it will be done while an anesthetic so you don't
experience too much pain.

Skin Traction – Skin traction is less invasive than skeletal

traction and uses splints, bandages, and adhesive tapes
positioned on the limb near the fracture and is applied directly
to the skin. Weights and pulleys are attached, and pressure is
applied. When a bone breaks, the muscles and tendons can
pull the extremity into a shortened or bent position. The traction
can hold the fractured bone or dislocated joint in place. This
can cause painful movement at the fracture site and muscle
cramping. Buck's traction is a type of skin traction that is widely
used for femoral, hip, and acetabular fractures, which are
fractures in the socket portion of the "ball-and-socket" hip joint.

USES O(F TRACTION

Knee affection Thoraco Lumbar Affection
1. To immobilize and support
2. To reduce and correct fracture
3. To maintain good alignment
4. To reduce pain and muscle spasms
5. To prevent deformities

TRACTIONS AND THEIR INDICATIONS

Head Halter- cervical spine affections

Side arm or Overhead-supracondylar

fracture of the humerus

Dunlop- suracondylar fx of the

humerus

90-90 degree-subtrochanteric
fracture of the P3 of the femur
TRACTION
TRACTIONS is the act of pulling or drawing which is Halo Pelvic - Scoliosis
associated with countertraction.

Halo femoral- severe scoliosis

COTREL TRACTION, a combination of head halter and pelvic

girdle traction.- Severe Scoliosis.

Bryant – Affections of the hips and

femur among children
under five years of age
Pelvic Girdle-Herniated Nucleus Pulposus, low back pain or
lumbosacral pain

Hammock Suspension-
Pelvic affection

Buck’s Extension-Affection
of the hips and femur

Boot Cast- Affections of the ankle and foot

Russell’s Traction- Affections of the femr and hips

Cervical Spine affection

Cervical Spine affection

SUMMARY