Plaster and braces are a method of healing used to protect the injured area by limiting the movement of the limb through immobilization. They are commonly used to treat injuries such as fractures, ligaments and tendons, and after some surgeries. Currently, traditional lime casts and polymer casts and supports are used. Types of fixation: Usually there are plaster rests that wrap half of the limb and fully wrapped tubular casts. According to the treatment process of plaster fixation, it can be generally divided into four periods: shaping period, early fixation period, fixation period and late removal period.
What are the issues to be noted in each period of plaster fixation?
I. Shaping period.
Lime plaster is generally in the process of gradually drying and solidifying within 1-2 days after production. At this time, the affected limb can be placed in a dry, high-temperature environment, which is conducive to accelerating the solidification of plaster shaping. At the same time, attention should be paid to protect the cast from collision and moisture. The plastered limb can be placed on a soft surface or a pillow can be placed under it. Do not rest the cast directly on the floor, table or chair during the shaping period as it is not yet dry, and do not stand and walk on the cast of the lower extremity to avoid affecting the shaping and the therapeutic effect. Water splash or wet environment will cause damage to the plaster, which will become soft and easy to break. Once the cast gets wet, it will not be able to achieve a strong fixation. If this happens, the plaster has to be replaced in time.
Polymer plaster is lighter and tougher than lime plaster and has a shorter shaping period. Theoretically, the outer layer of polymer plaster is waterproof, but in practice it still needs to be waterproof and moisture-proof. Because the inner layer is similar to lime plaster, it also uses cotton pads and other dressings that can easily absorb water, so excessive moisture may also cause blisters or breakage of the skin under the plaster.
II. Early fixation period.
After the molding period, the cast is basically solid, but the fracture or injured part of the limb is still in the swelling period. It is necessary to minimize the activity and take sufficient rest. If you feel that the cast is too tight, or if the local fixation continues to be painful and uncomfortable, it is recommended to seek medical attention and make adjustments.
Elevating the affected limb will help to relieve swelling and pain. Pillows can be placed under the cast to elevate the affected limb. Note that the pillow padding should be approximately the same length as the limb, not just one point. Pay attention to protect the lower part of the foot, such as the heel, to prevent pressure. The upper limb cast can be fixed with a sling or elevated with a pillow. For more severe injuries with swelling, try to elevate the patient above the level of the heart and maintain until the swelling improves.
Early icing is also beneficial in controlling bleeding and relieving swelling. You may choose to apply ice packs to the injury or to the gap around the cast, but make sure that the cast and wound are dry and do not get wet.
Proper movement of the ends of the limbs, such as fingers and toes, can promote blood return and help relieve swelling.
In addition, in the early stage of fixation, swelling and pain may be maintained for a period of time. At this time, you can take some anti-inflammatory and pain-relieving (such as NSAIDs type) and swelling-reducing drugs under the guidance of the doctor to help speed up the recovery.
III. Fixation period.
In this stage, the swelling and pain of the affected limb are basically relieved. The skin under the cast along with the swelling subsides easily to create a gap with the cast, and if the original swelling is more serious, it may create a larger gap, which may easily cause the cast to loosen or even the inner liner to break, directly causing the skin to contact the cast and damage the skin. If this happens, it is necessary to seek medical attention in time to avoid affecting the fixation effect and even skin infection.
As the swelling subsides, the skin under the cast becomes more mobile, sometimes causing itchy skin. At this time, you should not stick your fingers or other sticks into the cast to scratch the itch, which may directly damage the skin or destroy the inner lining of the cast, causing the skin under the cast to directly contact the surface of the cast and cause injury or even infection. The correct approach is to sprinkle some talcum powder in the plaster gap (but not recommended in plaster with wounds), or use a hair dryer to blow cold air in the plaster gap. If the symptoms are severe, you can also take over-the-counter anti-allergy medication at the same time, which will have a more significant effect.
Move the joints and muscles at the ends of the cast that are not fixed to prevent joint stiffness and muscle atrophy. For example, after the arm cast is fixed, the fingers can still be moved, so you can move your fingers and even make a fist every day. However, too much activity is not encouraged in the early stage, and once the sudden pain and swelling discomfort occurs, timely medical consultation is needed.
In general, it is not recommended to change the form and structure of the cast by oneself. If the edges of the cast appear rough and wear the skin causing pain. You can use abrasive skin to polish the rough edges. However, do not trim the cast with scissors as this may cause excessive damage and reduce the fixation effect.
The length of the cast fixation period is determined by the site and nature of the injury, and it is recommended to choose the appropriate fixation time under the guidance of the doctor.
IV. Late removal.
The cast is removed under the advice of the doctor. Simple casts can be removed on their own. Some special casts require special wheel saws to cut through and must be removed in hospital.
After the cast is removed, some injuries such as fractures or post-operative, are still in the recovery phase and still require proper protection and reduced activity. Please carry out the later rehabilitation and functional training under the guidance of your doctor.
Can I not move at all during the cast immobilization period?
During the cast immobilization period, whether you can move more or not depends on the type and location of the injury. Generally, you can move the surrounding joints and muscles appropriately to prevent stiffness and muscle atrophy. After the lower extremity injury is fixed in a cast, if the doctor allows the use of crutches or a walker, after the shaping period, you can walk and move with the help of the device, but the affected leg should not be stressed.
Most sports, such as cycling, are generally not recommended. It is best to have medical advice on whether some activities of daily living can be performed.
It is important to seek medical attention when the following conditions occur so as not to delay the condition?
1. Abnormal odor, or even foul smell, is emitted from the cast.
2.Fluid comes out from the cast.
3.Symptoms of general fever appear.
4.Sudden onset of pain, located at the point of fixation within the cast.
5.Observe the exposed finger or toe, if the exposed part becomes less and less and retracts into the cast, it may be that the cast is too loose or the fracture is displaced.
6.Numbness, pins and needles in the fingers or toes, sudden pain or inability to move on their own, even if the affected limb is elevated, cannot be improved.
7.It takes a long time to fix the cast, can I take a bath?
8.Bathing with a cast is usually difficult. If it is not possible to ensure that the cast is dry, it is recommended not to do so.
Usually we can use things readily available at home to protect the cast:.
1. first wrap a towel around the outside of the cast and secure it with an elastic bandage.
2, then wrap a larger plastic bag around the entire affected limb.
3, the upper mouth of the plastic bag will be sealed with adhesive tape (waterproof tape is more effective, but may be more irritating to the skin).
Of course, we can also buy special waterproof cuffs to protect the cast. However, no matter what method is used, the principle is to keep the plaster dry, never directly immerse the plaster in water.
Tips.
1.During the cast fixation period, try to reduce sweating and live in a dry and cool environment.
2, Pay attention to the exposed fingers or toes to keep them warm to avoid frostbite.
3.Check your cast support regularly, if there are cracks, breaks or slack, you need to alert your doctor if it needs to be replaced.
4.Frequently observe the skin around the cast, especially if the edge of the cast is red, swollen or worn out, and needs to be fixed by increasing the dressing pad again.
5.If the dressing pad inside the cast is damp and uncomfortable, you can use a hair dryer to blow cold air inside the gap of the cast.
6.The outer layer of polymer plaster is waterproof, if the plaster becomes dirty, you can gently wipe it with a wet cloth and detergent.