KYPOSIS

Presented by:Aqsa
Mehmood
presented to:Mam zara
saeed
Objectives;
• Kyposis
• The cast in child
• The traction
 KYPOSIS
Defination: kyposis is an abnormally
increased lateral angulation in the convex,
curvature of the supine.
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• it can occur secondary to disease
process such as tuberclosis(TB),chronic
arthritis,osteodystrophy,or compression
fractures of the thoroacic spine.
• The most common form of kyposis is
postural.
• children especially during the time when
skeletol growth of muscle,are prone to
exaggeration of a normal kyposis.
Scheuerman kyposis
it is a thoracic curve greater than 45
degree with wedging greater than 5
degrees of at least three adjacent
vertebral bodies and vertebral irregularity.
NURSING CARE
• assist parents in assinssing home environment for
hazerds.
• provide information about correcting identified
hazareds.
• Discuss common responsis to caring for a child with
a muscukosekeletol disorders.
• provide family with specific information on home
care
• its care based on exercise to strengthen shoulder
and abdominal muscles and bracing for more
marked deformity.
THE CAST IN
CHILD
The cast
casts are constructed from gauze strips
and bandages impregnated with plaster
of paris or ,more commenly,from
synthetic lighter weight and water-
resistant material(e.g.,waterproof liners,
fiberglass and polyurethane resine).
TYPES OF CAST
Cast Application
• During the application of the cast,
various distraction methods can be
used.,
• it include discussing favorite pets or
activites at school,blowing bubbles,and
so forth.
• In this age groups,explanations such as.,
• "This will help your arm get better"
are futile because the child has no
concept of causality.
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• Before the cast is applied ,the
extremities are cheked for any
abnormalities,cuts,or other alteration
in the skin surface and for the
presence of rings or other items that
might cause constriction from
swelling; such objects are removed.
• Dry rolls of casting material are
immersed in a pail of water.
• The wet rolls are put on in a bandage
fashion and molded to the extremity.
Nursing Management
• it should maintain the correct position with
complete comfort.
• if to tight there will be restrictions of blood
flow and sores may develop.
• Allow the cast to dry usually (24 to 72 hours).
• nerve impairment may occur.
• Handled the wet cast with palms not
fingertips.
• The cast should be well moulded to prevent
rational complications
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• keep the casted extremity Elevated
using a pillow.
• turn the extremity with equal for drying
do not use dryer for plaster cast.
• Assissing cast agdes for irritation.
• Monitring for increased pain.
• educating patient in care of cast.
Cast Removel
• cutting the cast to remove it or to relieve
tightness is frequently a frightening
experience for children.They fear the
sound of the cast cutter and are terrified
that their flesh,as well as the cast,will be
cut when placed tightly on the skin.
• children have described it as producing
a "tickly" sensation.
• The vibration also generates heat that
maybe felt by the child.
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• after the cast is removed,the skin
surface will be caked with disquamated
skin and sebaceous secretions.
• Application of minral oil(e.g.,baby oil)or
lotion may remove the particles as well
as provide comfort.
• soaking the extremity in a bathtub is
usually sufficient for their removal,but it
may take several days to eliminate the
accumulation completely.
THE TRACTION IN
CHILD
TRACTION
• Defination:Most balanced
skeleton traction is applied in children
afterba sever or complex. injury to
allow physiologic stability,align bone
fragment s,and permit closer
evaluation of the injured site.
Purposes of traction:
The six primary purpose of traction
are:
1.To fatigue the envolve muscles and
reduce muscle spasm so that bones
can be realigned
2.To position the distal and proximal
bone ends in desired realignment to
promote satisfactory bone healing.
3.To help prevent or improve
conttracture deformity.
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4.To provide immobilization of specific
areas of the body.
5.To reduce muscle spasm(rare in
children).
6.To immobilize tgr fracture site untile
realignment has been achieved and
sufficient healing has taken place to
permit casting or splinting.
Types of traction:
1.Manual Traction: Applied to the body
part by the hand placed distal to the fracture
site.Manual traction may be provide during
application of a cast but more commenly
when a closed reduction is performed.
2.Skin traction:Applied directed to the
skin surface and indirectly to the skeletol
structur.Both types are applied over soft,
foam-backed traction straps to distribute the
traction pull.
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3.Skeletal Traction: Applied directly
to the skeletal structure by a pain,wire,
or tongs inserted into or through the
diameter of the bone distal to the
fracture.
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• Observe the corect body alignment
with emphases on alignment of
shoulder.hips.and leg.
• check after child has removed.
• Maintain correct angles at joint.
• Assess straps or bandages to
ascertain if they are corectly applied.
• cleanse anf dress pib sites per
institution protocol or as orderd.
Nursing Managment of
traction:
• understand purpose of traction.
• check desire line of pull and
relationship of distal fragment to
proximal fragment.
• check position of bandages,frames,
splint,specialized boot.
• check bed position head or foot
elevated as directed for desired
amount of pull and counter traction.