Plastering and Immobilisation - Amplified
Fracture Principles
Goals of Immobilisation
- Pain relief
- Prevent further injury
- Maintain alignment
- Allow healing
When to Use Backslab vs Full Cast
Backslab (POP slab):
- Acute injuries (allows for swelling)
- Temporary immobilisation
- When expecting surgery
Full cast:
- Once swelling subsides
- Stable, non-surgical fractures
- Need complete immobilisation
Plaster Technique
Materials
- Tubifast: cotton liner
- Padding: cotton wool roll
- POP: plaster of Paris bandage
- Crepe: overwrap bandage
Application Steps
- Measure and cut POP (10-12 layers for forearm)
- Apply Tubifast liner
- Apply padding (minimal, smooth)
- Wet POP in lukewarm water
- Squeeze excess, apply to limb
- Mould to contours
- Fold liner edges back
- Wrap with crepe
Danger Signs
- Heat: POP generates heat when setting
- Compartment syndrome: pain out of proportion, pain on passive stretch
- Neurovascular compromise: numbness, pallor, pulselessness
Common Fractures and Positions
Colles Fracture (Distal Radius)
- Position: slight wrist extension, neutral rotation
- Sugar tong or volar backslab
- Wrist to MCP heads, below elbow
Scaphoid
- Thumb spica
- Include thumb to IP joint
- Wrist in slight extension and radial deviation
Ankle
- Below knee backslab
- Ankle at 90° (neutral)
- Avoid equinus position
Patient Education
- Keep dry
- Elevate when possible
- Return if: increasing pain, numbness, colour change, smell
- Follow-up in fracture clinic