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Slings, Casts, and Other Forms of Immobilization 1161

Slings, Casts, and Other Forms of Immobilization Client Education
Sheet
VetBooks.ir
Preparation: Important
Difficulty level: ♦
Checkpoints • Wrap the cotton as evenly as possible.
• Apply conforming gauze around the cotton
Synonym Wounds should be treated and an appropriate as tightly as possible, working from distal to
External coaptation dressing applied before splinting or bandaging. proximal.
• Cotton should be evenly compressed until
Overview and Goal Possible Complications and the bandage is firm to the touch.
To provide appropriate temporary support and Common Errors to Avoid • Pull the tape stirrups proximally, and apply
allow healing of musculoskeletal injuries, alone • The distal third and fourth digits should them onto the bandage. Their purpose is to
or as augmentation of surgical repairs be left visible whenever possible to allow prevent the bandage from slipping off the
monitoring for coolness, swelling, cyanosis, limb.
Indications or discharge, any of which warrants removal • Cover with a tertiary layer of conforming Procedures and Techniques
• Robert Jones bandage: temporary immobili- of the splint, cast, or bandage for closer tape.
zation of unstable fractures; control of edema evaluation of the soft tissues. • Goal of this bandage is even compression
and swelling; appropriate for open fractures • All bandages, splints, slings, and casts should and firm support over the entire limb.
after wound dressing be checked frequently for limb swelling or • Properly applied, the finished bandage should
• Splints: temporary immobilization of discoloration, skin abrasions, loosening or make a thumping sound like a ripe melon
fractures or peripheral joint luxations (p. slippage, moisture, or odor. when it is percussed.
1158); also used after surgery for joint • Severe ischemia can result from poor applica- • Tips of digits must be visible for monitor-
injuries, arthrodeses, or tendon injuries tion or management. ing. Due to high compression, this bandage
• Casts: immobilization of distal limb fractures can cause severe ischemic injury if applied
when mechanically stable; also appropriate Procedure poorly.
after surgical repair (similar to splints) Robert Jones bandage: Splints:
• Slings: partial immobilization of all joints of • Divide bulky roll cotton lengthwise and in • Apply tape stirrups as for the Robert Jones
the limb and prevention of weight bearing. thickness; reroll to create several smaller, bandage.
Ehmer sling is used primarily after reduction narrower rolls. • Apply cast padding, starting distally and
of hip luxation to prevent recurrence. • Apply adhesive tape stirrups directly to the winding around the limb as far proximally
skin of the medial and lateral or cranial and as needed.
Contraindications caudal surfaces of the distal limb, extending • Apply a layer of conforming gauze from distal
Excessive duration of immobilization may lead from the carpus or tarsus distally 4-6 inches to proximal area.
to muscle and joint contracture and permanent (10-15 cm) beyond the toes. • Place rigid splint material, usually on the
loss of mobility. Use with caution, especially • Apply cotton, winding it around the limb caudal or lateral side of the limb.
in pediatric animals. from distal to proximal as far as possible • Repeat another one to two layers of conform-
into the axillary or inguinal space. ing gauze.
Equipment, Anesthesia • Each turn of the cotton should overlap the • Cover with an outer layer of conforming
Sedation may be required for appropriate previous layer by 50%. tape.
placement of splints and bandages if animal
is in pain or uncooperative. General anesthesia
is required for reduction of fractures or joint
luxations before immobilization. Amounts
and widths of required materials depend on
animal size:
• Appropriate wound dressing, if needed
• A 0.5- or 1-inch (1.25- or 2.5-cm) width
roll of tape
• Rolls of cast padding, 2-6 inches (5-15 cm)
width
• Rolls of conforming gauze, 2-6 inches
(5-15 cm) width
• Rolls of self-adherent stretch tape
Additional materials:
• Roll of cotton, 12-inch (30-cm) width (for
Robert Jones bandage)
• Fiberglass resin or plaster-impregnated
casting tape, 2-4 inches (5-10 cm) wide for
casts A B C D
• Stretch stockinette (for casts, optional)
• Rigid Mason metasplint, lateral plastic limb SLINGS, CASTS, AND OTHER FORMS OF IMMOBILIZATION Robert Jones bandage. A, Adhesive tape
splint, fiberglass or thermoplastic splint (for stirrups (black) are applied to skin on opposite sides of distal limb. Wound dressing is applied as needed. Roll
splints) cotton (or for small patients, cast padding) is wrapped evenly around paw. B, Cotton is continued proximally,
well above site of injury, and with overlap of about 50% at each turn to create the full length of the bandage.
Anticipated Time C, Conforming gauze is applied in the same manner from distal to proximal but pulled tightly at each turn.
Cotton should be evenly compressed. D, Tape stirrups are reflected proximally and stuck to bandage. An outer
About 10-30 minutes for application of most tertiary layer of conforming elastic tape is applied over the cotton. Finished bandage should be firm with even
casts, splints, and slings compression over entire surface. Digits must be visible for monitoring.

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