Page 199 - ASOP ROT Study Guide

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dfix&soloState=lb&step=13&subStep=11&treatment=

The steps involved in wedging are as follows:
1. The patient is informed of the procedure and the reasons for it. He/she is suitably sedated for half

an hour in advance if this is felt necessary.
2. An X-ray is taken in two planes. The cast is marked at intervals with radiolucent markers such as

paper clips. This allows the exact level of the fracture to be identified relative to the cast.
3. Lines are drawn on the bones on the X-ray to show the angle to be corrected. The lines may also

be drawn on the cast.
4. The angle of correction is measured. This will be the same as the angle of the wedge to be cut.
5. The cast is marked at the point where the two lines drawn on the bones intersect. This mark will

be at a different level to where the bone ends currently meet. This is where the wedge is to be
cut.
6. The cast is cut round two thirds of its circumference - less will cause dangerous indenting by the
intact hinge.
7. The wedge is opened to the correct angle and held with the cut cork.
8. A new X-ray is taken to check the end result.
9. The cast is completed with the same material. The cork is removed where possible, or
positioned so that it does not cause an internal pressure point.
The dangers of wedging are in creating general and localized pressure points.

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