By Dr. Max Hoshino, Dr. Thomas Harris, Dr. John Tiberi III
- Quickly entry the specialist counsel you would like within the emergency room or workplace to regard orthopedic accidents caused by trauma, in addition to degenerative conditions.
- Reduce sufferer pain and increase results with step by step info on sufferer positioning, right immobilization, and anesthetic techniques.
- Avoid pitfalls and hone your abilities with useful guidance and tips from orthopaedic experts.
- See ideas in motion with instructive pictures, line drawings, and radiographs that supply crucial visible guidance.
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Extra info for Orthopaedic Emergency and Office Procedures
Use the patient’s unaffected arm to approximate the length of the splint. The appropriate length extends from the tip of the thumb along the radial boarder of the hand, wrist, and forearm to just distal to the elbow (Fig. 1-36). Figure 1-36 (c) 2014 Wolters Kluwer. All Rights Reserved. CHAPTER 1 • Basics of Splint and Cast Application 21 Apply sufficient cast padding (see “Cast Padding” section discussed previously). Apply the splint material. ■ Wrap with bias (Fig. 1-37). ■ ■ Tips and Other Considerations ■ It is typically easier to apply padding as sheets along the inside of the splinting material.
Figure 2-8 Closed Reductions Anterior Glenohumeral Joint Dislocation Indication Acute anterior glenohumeral dislocations can be treated successfully with a variety of closed reduction maneuvers. Glenohumeral dislocations greater than 4 weeks old should be treated with caution, because they are at a higher risk of postreduction instability, fracture, and injury to neurovascular structures. For these reasons, we limit closed reduction in the emergency room to dislocations less than 4 weeks old. Description of Procedure Regardless of the specific technique used, patient relaxation and comfort are paramount.
Maintenance of consistent ankle position during the application of the cast is essential, as manipulation after the plaster or fiberglass has been applied will create wrinkles or distortion of the casting material that can become pressure points, placing the patient at risk for ulceration. Tips and Other Considerations ■ The appropriate position of the ankle is dictated by the injury. For example, the ankle should be left in gravity plantar flexion for most tibia fractures, as dorsiflexion will cause recurvatum displacement of the fracture; however, with most ankle fracture injuries, effort should be made to immobilize the ankle in dorsiflexion.