Page 190 - ASOP ROT Study Guide

no place in fracture care, except in very rare cases such as a non-union.

2.6 Other Materials

There are a number of new commercially available splinting materials. These include foams which
can be sprayed on or applied to the limb in stocking shaped bags. These materials tend to be used
for specialised situations, such as spinal jackets or where a longer term removable splint is
required. Many of these materials do not tolerate much bending.

2.7 Indications for use of the Various Materials

2.7.1 Casting new fractures

Fresh fractures are associated with pain and swelling and may be unstable. Often the first cast
applied may be temporary and will be replaced once any swelling has gone. It may also be
necessary to manipulate a fracture back to an anatomically acceptable position which will restore
function - reduce it - and the splinting material needs to be versatile to fit around the manipulated
limb in order to hold it in the reduced position. In this situation plaster of Paris has the advantage of
ease and versatility of application and is inexpensive for making a temporary splint.

Polyurethane resin casts may be used for more stable fractures where there is little swelling (e.g. in
young people and the elderly). Young people tend to need hard wearing casts and so the extra
strength properties of polyurethanes may be beneficial. In the elderly, the lightweight properties
are useful in helping them to stay mobile.

2.7.2 Casting fractures after a few days

Once swelling has settled then there is a greater choice of material for a second cast. Expense is a
genuine consideration and the benefits of using a more expensive material must be justifiable.
Stronger casts need less attention and repair and so this may justify the use of more expensive
polyurethane resin casts. The patient may also benefit from the strength and lightweight properties
as described above.

2.7.3 Other uses

It is more important to appreciate the extra scope polyurethane resins give for casting techniques.
For example, because they are very strong they are excellent for constructing functional braces and
they interface very well with hinges. They are also flexible, so the splint may be opened and
closed without cracking. They can be interfaced with Velcro and other fastening materials making
them useful for removable splints, such as back supports.

Polyurethane resin casts may be used for more stable fractures where there is little swelling (e.g. in
young people and the elderly). Young people tend to need hard wearing casts and so the extra
strength properties of polyurethanes may be beneficial. In the elderly, the lightweight properties
are useful in helping them to stay mobile.

2.7.2 Casting fractures after a few days

Once swelling has settled then there is a greater choice of material for a second cast. Expense is a
genuine consideration and the benefits of using a more expensive material must be justifiable.
Stronger casts need less attention and repair and so this may justify the use of more expensive
polyurethane resin casts. The patient may also benefit from the strength and lightweight properties
as described above.

2.7.3 Other uses

It is more important to appreciate the extra scope polyurethane resins give for casting techniques.
For example, because they are very strong they are excellent for constructing functional braces and
they interface very well with hinges. They are also flexible, so the splint may be opened and
closed without cracking. They can be interfaced with Velcro and other fastening materials making
them useful for removable splints, such as back supports.