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AIRPLANE CAST indicated for humerus and shoulder joint with compound fracture BASKET CAST indicated for severe leg trauma with open wound or inflammation BOOT CAST - indicated for lower dorso-lumbar spine affectation BOOT LEG CAST - indicated for hip and femoral fracture CAST BRACE - indicated femoral fracture with flexion and extension COLLAR CAST - indicated for cervical affectation CYLINDRICAL LEG CAST - indicated for patellar fracture DELBIT CAST - indicated for fracture tibia or fibula DOUBLE HIP SPICA CAST - indicated for fracture hip and femur DOUBLE HIP SPICA MOLD - indicated for cervical affectation with callus formation FROG CAST - indicated for congenital hip dislocation FUNCTIONAL CAST - indicated for fracture humerus with adduction and abduction HANGING CAST - indicated for fractured shaft of the humerus. INTERNAL ROTATOR SPLINT - indicated for post hip operation LONG ARM CIRCULAR CAST - indicated for fractured radius or ulna LONG ARM POSTERIOR MOLD - indicated for fractured radius or ulna with compound affectation LONG LEG CIRCULAR CAST - indicated for fracture tibia-fibula LONG LEG POSTERIOR MOLD - indicated for fracture tibia-fibula with compound affectation MINERVA CAST - indicated for upper dorsal and cervical spine affectation MUNSTER CAST - indicated for fractured radius or ulna with callus formation NIGHT SPLINT - indicated for post polio PANTALON CAST - indicated for fracture of the pelvic bone PTB OR PATELLA TENDON BEARING CAST - indicated for fractured tibia fibula with callus formation QUADRILATERAL (ISCHIAL WEIGHT BEARING) CAST - indicated for shaft of the femur with callus formation RIZZERS JACKET - indicated for scoliosis SHORT ARM CIRCULAR CAST - indicated for wrist and fingers with compound affectation SHORT LEG CIRCULAR CAST - indicated for ankle and foot fracture SHORT LEG POSTERIOR MOLD - indicated for ankle and foot with compound affectation SHOULDER SPICA - indicated for humerus and shoulder joint affectation SINGLE HIP SPICA MOLD - indicated for fracture of the pelvis with callus formation 1 AND 1/2 HIP SPICA - indicated for hip and femur affectation 1 AND 1/2 SPICA MOLD - indicated for hip and femur with compound affectation

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Cylinder cast
In some cases, a cast may include the upper and lower arm and the elbow, but leaves the wrist and hand free, or the upper and lower leg and the knee, leaving the foot and ankle free. Such a cast may be called a cylinder cast, or may simply be called a long arm or long leg cast.

What is clubfoot?
Clubfoot, also known as talipes equinovarus, is a congenital (present at birth) foot deformity. It affects the bones, muscles, tendons, and blood vessels and can affect one or both feet. The foot is usually short and broad in appearance and the heel points downward while the front half of the foot (forefoot) turns inward. The heel cord (Achilles tendon) is tight. The heel can appear narrow and the muscles in the calf are smaller compared to a normal lower leg. Clubfoot occurs in approximately 1 in every 1,000 births, with boys slightly outnumbering girls. One of both feet may be affected.

What causes clubfoot?

Clubfoot is considered a "multifactorial trait." Multifactorial inheritance means there are many factors involved in causing a birth defect. The factors are usually both genetic and environmental. Often one gender (either male or female) is affected more frequently than the other in multifactorial traits. There appears to be a different "threshold of expression," which means that one gender is more likely to show the problem than the other gender. For example, clubfoot is twice as common in males as it is in females. Once a child has been born with clubfoot, the chance for it to happen again in a male or female child is about 4 percent overall. In other words, there is a 96 percent chance that another child would not be born with clubfoot.

What are the risk factors for clubfoot?

Risk factors may include:
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family history of clubfoot position of the baby in the uterus increased occurrences in those children with neuromuscular disorders, such as cerebral palsy (CP) and spina bifida oligohydramnios (decreased amount of amniotic fluid surrounding the fetus in the uterus) during pregnancy

Babies born with clubfoot may also be at increased risk of having an associated hip condition, known as developmental dysplasia of the hip (DDH). DDH is a condition of the hip joint in which the top of the thigh bone (femur) slips in and out of its socket because the socket is too shallow to keep the joint intact.

How is clubfoot diagnosed?

Your child's physician makes the diagnosis of clubfoot at birth with a physical examination. During the examination, your child's physician obtains a complete prenatal and birth history of the child and asks if other family members are known to have clubfoot. If the diagnosis of clubfoot is made in an older infant or child, your child's physician will also ask about developmental milestones since clubfoot can be associated with other neuromuscular disorders. Developmental delays may require further medical follow up to evaluate for underlying problems. Diagnostic procedures of the foot may include:
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x-ray - a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film. computed tomography scan (Also called a CT or CAT scan.) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce crosssectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.

The affected foot may be flexible, known as a "positional clubfoot." This flexible type of clubfoot is caused by the baby's position in the uterus. Positional clubfoot can easily be positioned into a neutral (not curved) position by hand. A true clubfoot is stiff, or rigid, and very hard to manipulate. The symptoms of clubfoot may resemble other medical conditions of the foot. Always consult your child's physician for a diagnosis.

Treatment for clubfoot:

Specific treatment for clubfoot will be determined by your child's physician based on:
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your child's age, overall health, and medical history the extent of the condition your child's tolerance for specific medications, procedures, or therapies expectations for the course of the condition your opinion or preference

The goal of treatment is to straighten the foot so that it can grow and develop normally. Treatment options for infants include:

nonsurgical treatment There are various methods of nonsurgical treatment for infants with clubfoot. These methods include serial manipulation and casting, taping, physical therapy and splinting, and use of a machine that provides continuous passive motion. A nonsurgical treatment should be the first type of treatment for clubfoot, regardless of how severe the deformity

is. According to the American Academy of Orthopaedic Surgeons (AAOS), the Ponseti method, which uses manipulation and casting, is the most frequently used method in the US to treat clubfoot. Most cases of clubfoot in infants can be corrected within 2 to 3 months using this method. It is recommended that Ponseti method treatment be started as soon as clubfoot has been diagnosed, even as soon as one week of age. The AAOS states that infants with clubfoot occasionally have a deformity severe enough that manipulation and casting will not be effective.

Because clubfoot may recur, braces are worn for several years to prevent relapse. Initially, the braces are worn for 23 hours a day for up to 3 months, then at night for 2 to 4 years.

surgery Surgical treatment for clubfoot may be required in these situations: when nonsurgical treatment fails to correct the deformity, or when the deformity recurs and does not respond to nonsurgical treatment. The specific surgical procedure and extent of surgery will depend on the type and extent of the deformity. Postoperatively, surgical wires, pins, and/or a cast may be used to maintain the corrected foot position until it has healed. Splints may also be needed for several months up to a few years after surgery.

What are long leg casts?

Long leg casts are applied from the upper thigh to the foot. These casts are used for thigh, knee, or lower leg fractures. They can also be used with knee dislocations or after surgery on the leg or knee area.

What are short leg casts?

A short leg cast is applied to the area below the knee to the foot. This type of leg cast is used for leg fractures and severe ankle sprains/strains or fractures. A short leg cast may also be used to hold the leg or foot muscles and tendon in place after surgery to allow healing. Illustrations of leg casts, 3 types

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Cast care instructions:

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Keep the cast clean and dry. Check for cracks or breaks in the cast. Rough edges can be padded to protect the skin from scratches. Do not scratch the skin under the cast by inserting objects inside the cast. Use a hairdryer placed on a cool setting to blow air under the cast and cool down the hot, itchy skin. Never blow warm or hot air into the cast. Do not put powders or lotion inside the cast. Cover the cast while your child is eating to prevent food spills from entering the cast. Prevent small toys or objects from being put inside the cast. Elevate the cast above the level of the heart to decrease swelling.

When to call your child's physician:

Contact your physician if your child develops one or more of the following symptoms:
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fever greater than 101 F increased pain increased swelling above or below the cast complaints of numbness or tingling drainage or foul odor from the cast cool or cold toes

Long-term outlook for a child with clubfoot:

Most infants with clubfoot can be corrected with serial manipulation and casting. Some infants may require surgery to help correct the position of the foot. Additional surgeries may be necessary since the deformity may come back as the child grows and develops.

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Is a temporary immobilization. Types: 1. Plaster 2. Fiber glass

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To promote healing and early weight bearing. To support, maintain and protect realigned bone. To prevent or correct deformity To immobilize

Cast Application

1. Apply the stockinette. 2. Apply the wadding sheet. 3. Fiber glass or the plaster cast

1. 2. 3. 4. 5. Pregnancy Skin disease Swelling Open wound Infection

Nursing Interventions
1. 2. 3. 4. 5. 6. 7. 8. 9. Handle wet cast with palms of hands, not fingers. Cast should be allowed to air dry. Elevate the cast on one or two pillows during drying. Observe hot spot and musty odor, which is signs and symptoms of infection. Maintain skin integrity petalling Do neurovascular checks such as skin color, skin temperature, sensation, mobility and pulse. Assess for vascular occlusion. Adhesive tape petals reduce irritation at cast edges. Prevent complication of mobility.

Types Of Cast, Molds And Indications

1. Airplane cast for humerus and shoulder joint with compound fracture. 2. Basket cast for severe leg trauma with open wound or inflammation. 3. Body cast for lower dorso-lumbar spine affectation. 4. Boot leg cast for hip and femoral fracture. 5. Cast brace for fracture of femur (distal curve) with flexion and extension. 6. Collar cast for cervical affectation. 7. Cylindrical leg cast for fractured patella. 8. Delbit cast for fracture of tibia or fibula. 9. Double hip spica cast for fracture of hip and femur. 10. Double hip spica mold cervical affectation with callus formation. 11. Frog cast for congenital hip dislocation. 12. Functional cast for fractured humerus with abduction and adduction. 13. Hanging cast for fractured shaft of the humerus. 14. Internal rotator splint for post hip operation. 15. Long arm circular cast for fractured radius or ulna

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Long arm posterior mold for fractured radius or ulna with compound affectation. Long leg circular cast for fractured tibia-fibula. Long leg posterior mold for fracture tibia-fibula with compound affectation. Minerva cast for upper dorsal or cervical affectation. Munster cast for fractured radius or ulna with callus formation. Night splint for post polio. Pantalon cast for pelvic bone fracture Patella tendon bearing cast for fractured tibia-fibula with callus formation. Quadrilateral (ischial weight bearing) cast for shaft of femur with callus formation. Rizzer s jacket for scoliosis Short arm circular cast for wrist and fingers. Short arm posterior mold for wrist and fingers with compound affectation. Short leg circular cast for ankle and foot fracture. Short leg posterior mold for ankle and foot with compound affectation. Shoulder spica for humerus and shoulder joint. Single hip spica for hip and 1 femur. Single hip spica mold for pelvic fracture with callus formation. 1 and hip spica for hip and femur. 1 and spica mold for hip and femur with compound affectation.