ORTHOPEDIC NURSING

Orthopedic Gadget- a piece of special device designed to correct deformoities or to preserve

and restore the function of the musculo-skeletal system

- This includes tractions, braces, casts, molds and splints

Purpose:

 To maintain good body alignment

 To prevent and correct deformity
 To reduce pain and muscle spasms
 For immobilization
 For support
 To reduce fracture

I. TRACTION
- The act of pulling and drawing which is associated with counteraction
3 Classifications:
1. Manual- a pulling force by the hands of the operator
2. Skeletal- a pulling for applied directly to the bones using wires, pins, or tongs
3. Skin- pulling force is applied to the skin, transmitted to the muscle, then to the bones

Types of Skin Traction

a. Adhesive- use of adhesive tape, bandage, wooden spreader and wadding sheet
b. Non-adhesive- use of canvass, slings, leathers, straps with buckles, laces and ribbons

II. BRACE
- A device that is externally applied to support the body to control movement and
prevent further injury
Eg. Milwaukee brace- indicated for affection of T9 and below

III. CASTS
- A rigid external immobilizing device molded to follow the contour of the body part
- Made up of either plaster of Paris or fiber glass
Eg. Log leg circular cast- for affection of tibia-fibula

A. Skin Tractions
 Skin non-adhesive
1. Ankle traction
Indication: for the affection of hip and femur
2. Pelvic traction
Indication: for affection of the lumbar spine
3. Head halter traction
Indication: for affection of the cervical spine
4. Hammock suspension traction
Indication: for the affection of the pelvis
5. Cotrel Traction
Indication: for mild scoliosis
 Skin adhesive
1. Buck’s extension traction
Indication: for the affections of hip and femur
2. Bryant’s traction
Indication: for the affections of hip and femur in children below 6 years old
3. Dunlop traction
Indication: for supracondylar fracture of the humerus
4. Zero degree traction
Indication: for the fracture of neck of humerus

B. Skeletal tractions
1. Balance skeletal traction (BST)
Indication: fracture of femur
2. Boot cast traction
Indication: fracture of the hip and knee
3. Overhead traction
Indication: supracodylar fracture of humerus
4. Halo-pelvic traction
Indication: for severe scoliosis
5. Halo-femoral traction
Indication: for scoliosis
6. Halo-vest
Indication: for cervical spine affectation
7. Crutchfield traction
Indication: for cervical spine fracture

IV. BRACES
1. Shantz Collar
Indication: cervical spine affection
2. Philadelphia neck brace
Indication: cervical spine affectation
3. Sterno-occipito-mandibular immobilizer (SOM)
Indication: fracture of C4/5 –T3/4
4. Chairback brace
Indication: lumbo-sacral affection
5. Jewett brace
Indication: lower thoracic affection
6. Taylor brace
Indication: upper thoracic affection
7. Forrester brace
Indication: cervico-thoraco-lumbar affection
8. Milwaukee brace
Indication: scoliosis (T9 and below)
9. Yamamoto brace
Indication: T9 and above)
10. Banjo splint
Indication: to prevent peripheral nerve injury
11. Opennheimer finger splint
Indication: to prevent radial nerve injury
12. Bilateral long leg brace
Indication: Post polio with residual paralysis
13. Unilateral long leg brace
Indication: One leg post polio with residual paralysis
14. Atlanta brace
Indication: to prevent avascular necrosis of femur
15. Dennis brown splint
Indication: to reduce club foot
16. Cock-up splint
Indication: to prevent wrist drop

CASTS AND MOLDS

1. Cylinder cast
Indication: fracture of patella
2. Short leg circular cast
Indication: fracture or ankle and foot
3. Long leg circular cast
Indication: fracture of tibia and fibula
4. Patellar tendon bearing cast
Indication: fracture of tibia and fibula with callus formation
5. Quadrilateral cast (Ischial weight-bearing cast)
 Indication: fracture of shaft of femur with callus formation
6. Cast brace
Indication: fracture of femur (allowing flexion and extension)
7. Delbit cast
Indication: fracture of tibia-fibula which allows ankle and foot movement
8. Basket cast
Indication: severe knee trauma with open wound or inflammation allowing drainage of
secretions
9. Short arm circular cast
Indication: fracture of wrist and fingers
10. Long arm circular cast
Indication: fracture of the radius-ulna
11. Fuensters of munsters cast
Indication: fracture of the radius-ulna with callus formation
12. Hanging cast
Indication: fracture of the neck/shaft of the humerus
13. Functional cast
Indication: affection of the shaft of the humerus to allow flexion and extension of the
humerus with callus formation
14. Shoulder spica cast
Indication: fracture of humerus and shoulder joint
15. Abduction splint/airplane cast
Indication: fracture of the humerus and shoulder joint with compound affectation
16. Rizzer’s jacket
Indication: affection of the thoraco-lumbar spine; scoliosis (s-type)
17. Minerva cast
Indication: upper dorsal cervical spine affectation
18. Collar cast
Indication: cervical spine affection
19. Body cast
Indication: lower thoracic and upper lumbar spinal affection
20. Pantalon cast
Indication: pelvic bone fracture
21. Frog cast
Indication: for congenital hip dislocation
22. 1 and ½ hip spica cast
Indication: hips and femur fracture
23. Double hip spica cast
Indication: fracture of hips and 2 femurs
24. Single hip spica cast
Indication: hip and 1 femur fracture
25. Short arm posterior mold
Indication: fracture of wrist and fingers with compound affectation
26. Sugar tong
Indication: compound affection of the humerus with open wound, inflammation or
swelling
27. Short leg posterior mold
Indication: fracture of ankle and foot with compound affectation
28. Long leg posterior mold
Indication: fracture of tibia-fibula with compound affectation
29. Night splint
Indication: for post-polio
30. Single hip spica mold
Indication: fracture of hip and femur with compound affection
31. Double hip spica mold
Indication: fracture of hip and femur with compound hip affection