1

BALANCE SKELETAL TRACTION 2. Inform the patient about the need and purpose of
the procedure to allay the patient's anxiety and to
elicit cooperation.

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Traction – is the act of pulling and drawing which is 3. Preparation:

on
associated with counter traction. a) Identify the different parts of the
orthopedic bed

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Indications:
● Balkan frame:
For the affection of the hip and femur ⮚ 4 vertical bars

.L
⮚ 2 horizontal bars
Purposes:
⮚ 1 diagonal bar

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S – support ⮚ 2 straight or cross bar
P – prevent or correct deformity ⮚ 1 curved bar
I – immobilization

by
● Firm mattress
R – reduce fracture
● Fracture board
R – reduce muscle pain and spasm
b) Gather equipment needed for BST:

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M – maintain good body alignment
● Thomas splint
● Pearson’s attachment
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APPLICATION OF TRACTION ● Rest splint
● 3 cord/ropes/sashes
ep

1. Verify/check doctor’s order to know the patient,

the site of affection, and to check the weights to ● 5 slings
Pr

be used. ● 5 safety pins/paper clips

● 3 pulleys
● Weights

BST AUBREY V. LEDONIO (Clinical Instructor - Orthopedic Nursing

 2

⮚ Traction weight – 10% of a. Not too tight and not too loose
patient’s body weight b. One (1) inch distance in between
⮚ Suspension weight – 50% of the the slings to promote aeration or

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traction weight ventilation

on
● Steinman’s pin holder c. Popliteal area and heel portion
● Foot board should be free from any slings

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● Overhead trapeze d. Smooth and right side should
4. Assemble the Thomas splint and Pearson’s come in contact with the

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attachment patient’s skin to avoid friction
● Estimate/measure the length of the and irritation

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thigh to ensure that the screws of the e. Two (2) longer and wider slings
Pearson’s is in line with the knee for the thigh portion (Thomas)

by
● The Pearson’s attachment must be and the three (3) for the leg
under the Thomas splint area (Pearson)
5. Mount the Thomas and Pearson’s on the rest 7. Tie the thigh rope (shortest) on the medial
splint
6. Apply the slings
ed upright of the Thomas with a slipknot and
secure the other end of the rope at the
ar
● Start from the medial side to the screw of the Pearson
lateral side, secure both ends 8. Insertion of the apparatus under the
ep

together, fan fold nicely on the lateral affected extremity

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aspect and secure with a pin or clip Three manpower needed:

● Observe the Principles in Sling ● 1st person to insert the whole apparatus
Application: under the affected extremity

BST AUBREY V. LEDONIO (Clinical Instructor - Orthopedic Nursing

 3

● 2nd person to perform manual traction holder with a slipknot; the other end is
to be released after the attachment to run along the third (3rd) pulley.
of the traction weight on the third Attach the prescribed weight.

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pulley is secured 11. Application of suspension weight

on
rd
● 3 person to support and lift the ● The loose end of the thigh rope is
affected extremity attached to the lateral aspect of the

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ischial ring with a slipknot.
This is to be done simultaneously at the count of
● Attach suspension rope (longest) at the

.L
three (3).
mid-part of the thigh rope with a
slipknot

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Instruction to patient: ● Insert the end of the suspension rope
to the 1st pulley
Hold on to the trapeze, flex the unaffected leg and

by
● Insert the suspension weight and hang
at the count of three (simultaneous with the insertion of it on the first pulley
the apparatus) will lift the buttocks of the affected side. ● Insert the suspension rope to the

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9. Check if the principles of sling application are
followed; check the alignment; and make
second pulley then pass it under the
rest splint, outside the traction rope,
ar
necessary adjustments. Adjust also the and tie it to the Thomas splint with a
clove hitch knot and tie it again to the
ep

Pearson's attachment if not aligned with the

patients’ knee. Pearson’s attachment with another
Pr

10. Application of the traction weight. clove hitch knot.

● One end of the traction rope (longer ● Consume the remaining rope
rope) is attached to the Steinman pin 12. Remove the rest splint

BST AUBREY V. LEDONIO (Clinical Instructor - Orthopedic Nursing

 4

13. Apply foot board (using ribbon knot) to 5) Avoid friction

prevent foot drop ● Rope should be running along the
14. Check the efficiency of the traction by groove/canal of the pulley

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swinging the patient to and fro, side to side. ● Knots should be away from the

on
(Give the patient the same instructions during pulley
the insertion of the apparatus). ● Weight should be hanging freely

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15. Check the Principles of Traction: ● Observe for wear and tear of
1) Patient should be in dorsal recumbent the ropes and bags

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position
2) Provide counter traction – patient’s

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body weight will serve as the counter REMOVAL OF TRACTION
traction 1. Check the doctor’s order

by
3) The line of pull should be in line with 2. Explain the procedure to the patient
the deformity 3. Apply the rest splint
● 1st pulley should be in line with 4. Hang the suspension weight on the 1st pulley
ed
the thigh
● 2nd pulley should be in line with
5. Completely remove the suspension rope
ar
6. Loosen the thigh rope on the lateral aspect of
the knee the ischial ring and secure the loose end on
● 3rd pulley should be in line with
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the screw of the Pearson’s

the 1st and 2nd pulleys 7. Apply manual traction on the Steinman pin
Pr

4) Traction should always be continuous – holder

importance of manual traction should 8. Remove the traction weight
be emphasized

BST AUBREY V. LEDONIO (Clinical Instructor - Orthopedic Nursing

 5

9. Remove the traction rope from the third c) Urinary and kidney problem – good perineal
pulley and secure the loose end on the rest care, increase fluid intake
splint with a clove hitch knot; another knot d) Bowel complication – fear of apparatus, no

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on the Thomas and the Pearson attachment privacy, lack of fluids, perineal care

on
e) Pin site infection – observe for S/S of
infection – loosening pin tract, pus coming out,

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NURSING CARE OF PATIENTS’ WITH TRACTION foul smelling drainage/pin site, fever
1. Assessment – assess the patient as to level of f) Deformity – contracted knee, atrophy of

.L
understanding, consciousness muscles, foot drop, joint contractures
2. Provision of general comfort: 4. Provision of exercise:

:A
a) Skin care – head to toe, focus on sponging of a) ROM exercises with the use of the trapeze
the affected extremity b) Deep breathing exercises

by
b) Changing of linen, slings c) Static quadriceps exercises – alternate
c) Provide bedpan as needed contraction and relaxation of quadriceps
d) Perineal care muscles

ed
3. Assess for potential complication d) Toes pedal exercises
5. Nutritional status – depending on the status of the
ar
a) Upper respiratory – PNEUMONIA – provide
bronchial tapping and teach deep breathing patient – encourage patient to increase intake of
foods rich in fiber, protein, vitamin C and calcium;
ep

exercises
b) Bedsore – good perineal care, proper skin increase fluid intake
Pr

care, turning or positioning/lifting of 6. Psychological aspect – fear of unknown, fear of

buttocks once in a while death, fear of the apparatus, fear of losing job,
financial fear

BST AUBREY V. LEDONIO (Clinical Instructor - Orthopedic Nursing

 6

7. Provision of supportive therapy – offer books to CHECKLIST FOR BALANCE SKELETAL TRACTION
read; discover interest; encourage listening to radio APPLICATION AND REMOVAL
or watching movies/televisions if available

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ACTIVITY/ACTION POINTS
8. Spiritual aspect – know his religion, encourage I. Purpose & Indications of Traction 10

on
relatives to read him verses from the Bible II. Identification of parts of an: 10
9. Diversional activities – logic games/crossword A. Orthopedic Bed (5)

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puzzles B. Equipment for BST (5)
III. Traction Set-up: 10

.L
A. Thomas splint/Pearson Attachment/Rest splint (3)
B. Application of slings (3)
C. Principles of sling application (4)

:A
IV. Insertions of apparatus on affected Extremities: 10
A. 3 manpower team (5)

by
B. Patient’s Instructions (5)
V. Procedure: 20
A. Application of Traction weight (5)

ed B. Application of suspension weight

C. Removal of rest splint
(5)
(5)
ar
D. Applying of foot support (5)
VI. Checking of Efficiency of Traction: 10
ep

A. Principles of Traction
VII. Transport/Removal of Traction 10
Pr

VIII. Nursing Care and Management of Complications 20

TOTAL: 100

BST AUBREY V. LEDONIO (Clinical Instructor - Orthopedic Nursing

 REVIEW OF THE SKELETAL SYSTEM
2 Types of Bone Tissues:

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5 General Functions of the Skeletal System:

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1. Compact Bone or Dense Bone – Also called cortical bone. It forms
the hard external layer of all bones and surrounds the medullary
1. Supports and stabilises surrounding tissues

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cavity or bone marrow. This provides protection and strength to
2. Protects vital organs of the body
bones.
3. Assist in body movement
2. Spongy Bone or Cancellous Bone – Forms the inner layer of all

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4. For hematopoiesis
bones. It is softer compared to the compact bone. Spongy bone
5. Storage of minerals
reduces the density of bone and this allows the end of the bones

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2 Main Division of the Skeletal System: to compress at times when stresses are encountered by the bone.

1. Axial Skeleton – composed of 80 bones; involving the following:

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a) the vertical and central axis of the body,
4 Cell Types in Bones:
b) cranial and facial bones

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c) vertebrae – composed of 7 cervical, 12 thoracic, 5 1. Osteoblasts – are bone cells responsible for the formation of the
lumbar, 5 sacral (fused into 1); and 4 coccyx (fused into 1) bone. It synthesises and secrete both the organic (mineral
vertebras component which comprises the calcium and phosphate and

:
d) ribs – composed of 12 pairs (7 pairs of true bones, 3 pairs other minerals) and inorganic (collagen fibers) part of the
of false ribs, 2 pairs of floating ribs)
e) hyoid bone by extracellular matrix of the bone tissue. This would later on
develop into less active osteocytes.
d
f) sternum 2. Osteocytes – these are mature bone cells and are the main cells
2. Appendicular Skeleton – composed of 126 bones; comprising the in bony connective tissue. It involves bone resorption that
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following parts: contributes to bone remodelling in response to growth or in
ar

a) Upper Extremity – includes the clavicle, acromion, response to any stress encountered by the bone. It participates
glenoid, scapula, humerus, radius, ulna, carpal, also in maintaining long-term blood calcium homeostasis.
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metacarpal, & phalanges 3. Osteoclasts – are large bone cells responsible for removing bone
b) Lower Extremity – includes the pelvis, acetabulum, femur, structure by releasing lysosomal enzymes and acids that dissolve
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patella, tibia, fibula, tarsal, metatarsal, & phalanges the bony matrix. They play an important role in bone remodelling
together with the osteoblasts. It stimulates osteoblasts activity.

HARDWARE/ANATOMY AUBREY V. LEDONIO (Clinical Instructor) Orthopedic Nursing

 4. Osteoprogenitor Cells – has the ability to produce daughter cells PATTERNS OF FRACTURES:
that would differentiate into osteoblasts. This cell is important in
the repair of fractures. Transverse - a fracture that is straight across the bone. Usually

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caused by a force applied directly to the site at which the

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fracture occurs.
Oblique -a fracture occurring at an angle across the bone (less

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FRACTURE
stable than transverse).
● Any break in the continuity of the bone
Spiral - a fracture twisting around the shaft of the bone. Usually
● A traumatic injury resulting in partial or complete

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caused by a violence transmitted through the limb from a
disruption in the continuity of osseous tissue of the bone
distance.
Comminuted - a fracture in which bone has splintered into
CLINICAL MANIFESTATIONS OF FRACTURE:

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several fragments.

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Depressed - a fracture in which fragments are driven inward
● Pain • False motion (seen frequently in fractures of the skull and facial bones).
● Loss of function • Shortening of Compression - a fracture in which bone has been compressed

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the extremity (seen in vertebral fractures).
● Deformity • Discoloration Fatigue or Stress Fracture – in which the bone breaks after

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of the skin repeated stress. This phenomenon is associated with
● Swelling • Paresthesia soldiers who may break bones during prolonged
● Crepitus marching.
● Tenderness

CLASSIFICATION OF FRACTURES:
by Greenstick - a fracture in which one side of a bone is broken and
the other side is bent; occurs in children whose bones are
soft and yielding. The bone bends without fracturing
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across completely, the cortex on the concave side
1. CLOSED FRACTURE (or Simple Fracture) – disruption in the
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usually remaining intact.
continuity of the bone without skin breakage. Impacted - fractured surfaces are driven together into the other
2. OPEN FRACTURE (or Compound Fracture) - there is bone
a

bone fragment.
disruption with skin breakage and involvement of the Segmental - a bone break in which several large bone fragments
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underlying soft tissues leading directly into the fracture site. separate from the main body of a fractured bone. The
3. INCOMPLETE FRACTURE – a fracture involving only a portion of ends of the fragments may pierce the skin, as in an open
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the cross section of the bone, usually undisplaced. fracture, or may be contained within the skin, as in closed
4. COMPLETE FRACTURE – a fracture involving the entire cross fracture.
section of the bone, usually displaced.

HARDWARE/ANATOMY AUBREY V. LEDONIO (Clinical Instructor) Orthopedic Nursing

Fracture Dislocation or Subluxation – a fracture which involves a 2. Inflammation and Cellular Proliferation – this takes place at the
joint and results in mal-alignment of the joint surfaces. fracture site, where torn ends of periosteum, endosteum and
bone marrow supply the cells which proliferate into fibrocartilage,

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hyaline cartilage and fibrous connective tissue. The tearing away

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CAUSES of FRACTURE: of periosteum by the injury serves as a stimulus to its deep layers
so that proliferation of osteoblast also takes place. The fibrous

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1. Direct Force - when the bone absorbs more stress that it layers of periosteum are elevated away from the bone. After
cannot endure from the impact of a solid object such as from several days, the combination of periosteal elevation and the

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direct blow or fall from a height or a crushing injury from granulation tissue forms a collar around the end of each
vehicular accidents. fragment. These collars eventually advance, unite and form a
2. Indirect Force - bone breaks at a site different from where the bridge across the fracture site.

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force was actually applied such as twisting force that usually
causes spiral fractures. 3. Callus Formation – Tissue growth continues and the cartilage

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3. Powerful Muscle Contractions - in which highly developed collar from each bone fragment grows toward the other until the
muscles contract so violently that muscle tears from bone fracture gap is bridged. The fracture fragments are joined by

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(at times can cause pulling of small pieces of bone with it). fibrous tissue, cartilage and immature fiber bone. An internal
E.g. Grand Mal Seizure condition. callus also develops and invades the remaining blood clot.

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4. Pathologic Decay – bones are weakened by diseases such as The shape of the callus and the volume of tissue required to
osteoporosis and becomes susceptible to fracture even with bridge the defect are directly proportional to the amount of bone
a minimal movement. damage and displacement. It takes 3-4 weeks for fracture

fractures of the foot, ankle, tibia or hip. by

5. Repetitive Forces – those caused by running which can cause fragments to be united by cartilage or fibrous tissue. Clinically, the
fragments are no longer easily moved.
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4. Callus Ossification or Union Stage – ossification of the developed
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STAGES OF BONE HEALING: callus begins within 2-3 weeks. The mineral deposition continues
and produces a firmly reunited bone. The callus surface continues
to be electronegative. With major adult long bone fractures,
a

1. Hematoma – when a bone is fractured, blood extravasates into

ossification takes 3-4 months.
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the area between and around the fragments and the bone
marrow. The formation of hematoma clot begins 24 hours after
the fracture occurs. Through this fibrin network, young fibroblasts 5. Consolidation and Remodelling – while calcium salts continue to
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and new capillaries invade the clot and granulation tissue is be deposited, excess callus and bone resorption begins.
formed to replace the hematoma.

HARDWARE/ANATOMY AUBREY V. LEDONIO (Clinical Instructor) Orthopedic Nursing

Terminologies: Sprain - is an injury to the ligamentous structures
surrounding a joint caused by a wrench or a twist
Anterior - Toward or at front of the body Strain - a “muscle pull” due to overuse, overstretching or

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Concave - curving in or hallowed inward excessive stress

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Convex - curving out or extending outward Subluxation - partial or incomplete dislocation
Distal - farther from the origin of a body part or the point

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of attachment of a limb to the body trunk
Dorsal - towards the back Types of Body Movement:

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Inferior - away from the head end or toward the lower part
of a body structure (below) Flexion – decreases the angle at joint between two bones
Inter - (in) between Extension – increases the angle between the two bone; extension returns

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Intra - within a body part from the flexed position
Lateral - away from the midline of the body; on the outer Hyperextension – continues the act of extension beyond the original

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side of anatomical position
Medial - toward or at the midline of the body; on the inner Abduction – moves a bone in appendicular skeleton away from the body’s

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side midline
Posterior - toward or at the back of the body Rotation – turning of a body part around an axis

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Proximal - closer to the origin of the body part or at the Circumduction – rotating an extremity in a complete circle. It is a
point of attachment of a limb to combination of abduction, adduction, extension and flexion
the body trunk Pronation – turns the palm, foot or body toward the floor
Sub
Superior
-
- by
prefix signifying under, beneath, near
toward the head end or upper part of the body
structure (above)
Supination – turns the palm, foot or front of the body towards the ceiling
Inversion – turns an extremity or part of the extremity inward toward the
body’s midline
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Supra - a prefix meaning, above or over Eversion – turns an extremity or part of an extremity outward from the
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Ventral - towards the belly body’s midline
Contusion - an injury to the soft tissues produced by blunt External Rotation – motion around central axis away from the midline
a

force (e.g. blow, kick, fall). There is always Internal Rotation – motion around a central axis toward the midline
bleeding into the injured part (ecchymosis) due to Dorsiflexion – movement that decreases the angle between the dorsum
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the rupture of small vessels. This leads to skin (superior surface) of the foot and the leg so that the toes are
discoloration (bruising). brought closer to the shin.
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Dislocation - a condition in which the articular surfaces of the Plantar Flexion – movement of the foot that flexes the foot or toes
bones forming the joint are no longer in downward toward the sole
anatomical contact. Protraction – movement of the body in the anterior direction

HARDWARE/ANATOMY AUBREY V. LEDONIO (Clinical Instructor) Orthopedic Nursing

Retraction – movement of the body in the posterior direction 24. RFS – Rush Frozen Section
Elevation – moving the body part in an upward position 25. CHSF – Compression Hip Screw Fixation
Depression – moving the body part in a downward motion 26. STSG – Split Thickness Skin Grafting

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27. SSI – Segmental Spinal Instrumentation

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28. TBW – Tension Band Wiring
29. TAR – Tendon Achilles Repair

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COMMON SURGERY ABBREVIATIONS 30. THRP – Total Hip Replacement Prosthesis
31. VDO – Varus Derotation Osteotomy

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1. ACL – Anterior Cruciate Ligament
2. ADSF – Anterior Decompression Spinal Fusion
3. AEA – Above Elbow Amputation COMMON ANESTHESIA ABBREVIATIONS

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4. AKA – Above Knee Amputation

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5. BKA – Below Knee Amputation
6. BG – Bone Grafting

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1. ABPB – Axillary Brachial Plexus Block
7. CHSF – Compression Hip Screw Fixation 2. SAB – Subarachnoid Block
8. CSTR – Complete Soft Tissue Release 3. GETA – General Endotracheal Anesthesia

:A
9. CW – Cerclage Wiring 4. GOTA – General Orotracheal Anesthesia
10. DCS – Dynamic Compression Screw 5. GA – General Anesthesia
11. FTSG – Full Thickness Skin Grafting 6. SA – Spinal Anesthesia
12. HRI – Harrington Rod Instrumentation
13. IMN – Intramedullary Nailing
14. ORSF – Open Reduction Screw Fixation
by 7. CLEA – Continuous Lumbar Epidural Block
8. SCBPB – Supraclavicular Brachial Plexus Block
d
15. ORIF – Open Reduction Internal Fixation
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16. PLBG – Postero-Lateral Bone Grafting
17. PMR – Posterior Medial Release
a

18. PHRA/PHRP – Partial Hip Replacement

Arthroplasty/Prosthesis
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19. PSF – Posterior Spinal Fusion

20. PSTR - Postero Soft Tissue Release
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21. PSR – Progressive Surgical Release

22. RAEF – Roger Anderson External Fixation
23. ROI – Removal of Implant

HARDWARE/ANATOMY AUBREY V. LEDONIO (Clinical Instructor) Orthopedic Nursing

 ORTHOPEDIC HARDWARE

Principles in the Management of Fracture: (4 R’s)

1. RECOGNITION – Involves history taking skills of nurses to assess the type of fracture and its
manifestations specifically the signs and symptoms.
2. REDUCTION – Putting back the bone to its proper alignment. It is categorized into two:
a) Close Reduction – manual manipulation of the bone back to its proper alignment
b) Open Reduction – surgical intervention in aligning the bone back to its normal form
3. RETENTION/IMMOBILIZATION – Maintaining the alignment of the fractured bone using
immobilization gadgets such as Cast, Traction, External Fixators and Orthopedic Braces.
4. REHABILITATION – Putting and helping the patient achieve the optimum level of functioning
after having the Retention Phase.

Common Orthopedic Hardware and Internal Fixators & Its Uses:

BONE DRILL & DRILL BIT

ANTIBIOTIC BEADS
*For boring hole through the bone (Provides therapeutic
effect for Osteomyelitis;
Provides prophylactic
effect in plating, IMN,
and other types of
Internal and External
Fixators)

OSTEOTOMES (CHISEL) SUB-LAMINAR WIRE

*Used for obtaining bone chips for spinal fusion *To hold rod in place during instrumentation
*Used for scraping dead/necrotic bone tissues specially for Scoliosis

1
 LUQUE ROD & CERCLAGE WIRE
HARRINGTON ROD * For fracture of the patella, used in
* Instrumentation for Scoliosis Tension Band Wiring

HEMOVAC/BAROVAC DRAIN
INTRMEDULLARY * For collection of drainage under
GIGLI SAW NAIL EXTRACTOR negative pressure
* To cut bones during amputation * For removal of IM
Nailing

CRUTCHFIELD
TONG
SKIN STAPLER * Applied at
* To hold skin Parietal area for
edges together cervical traction
post operatively application

WIRE CUTTER
* To cut wires

INTRAMEDULLARY
NAIL (IM) with
LOCKING SCREW
* For fracture of
the middle 3rd or
Distal Femur

2
 RONGEUR INTRAMEDULLARY INTRAMEDULLARY
* For cutting NAIL (IM) with NAIL (IM) only
bone chips LOCKING SCREW * For fracture of
* For fracture of the tibia
Distal Tibia

BONE PLATES
* For long bone fractures and not
comminuted in appearance

T- PLATE or BUTTRESS PLATE

* For fracture of Proximal
Tibia

STEINMANN PIN
* Used for long bones

COMPRESSION PLATE & SCREWS

* For Compression Hip Screw
Fixations
* Intertrochanteric /Sub
trochanteric Fracture of the Femur

ROGER ANDERSON EXTERNAL FIXATOR (RAEF)

* For comminuted fracture of the long bone

3
 BIPOLAR HIP PROSTHESIS BIPOLAR HIP PROSTHESIS with ACETABULAR
* For partial hip replacement arthroplasty CAP
(PHRA) * For total hip replacement arthroplasty (THRA)

KNEE PROSTHESIS
SPACER ANTIBIOTIC
(with Femoral and Tibial Component)
* Replacement of infected hip
* For total knee replacement arthroplasty
prosthesis
* For degenerative knee joint diseases, fracture of the distal
femur and proximal part of the tibia, and rheumatoid arthritis of
the knees

HYBRID EXTERNAL FIXATOR

ILIZAROV * For peri-articular fracture of the ankle or
* For comminuted fracture, non-union, mal-union knee joint, or near the joints
and for bone growth & lengthening

4
 COMMON EXAMPLES OF EXTERNAL FIXATORS ATTACHED TO ACTUAL
PATIENTS:

SPANNING EXTERNAL FIXATOR

* For fracture of the knee joint, distal part of
femur extending to the proximal part of the
tibia/fibula

DELTA FRAME
* For fracture of the peri-articular area of
the joint, proximal portion of the tibia

DELTA FRAME
* Applied with short leg
posterior mold and
rested/placed on a Bohler
Braun Splint

INVERTED DELTA DELTA FRAME DEN

FRAME HAM (ANKLE BRIDGE)
* Applied when there * The frame is
is severe soft tissue extended to the ankle
involvement that can to give way to soft
interfere the insertion tissue granulation and
of pins healing
5
 ROGER ANDERSON EXTERNAL FIXATOR QUADRILATERAL EXTERNAL FIXATOR
(RAEF) * For fracture of the middle 3rd of tibia
* For comminuted fracture of the long bone fibula, comminuted
* Can be used both on upper and lower
extremity)

6
 PR
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SKELETAL TRACTION

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TRACTION

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 SKIN TRACTION (Adhesive)

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SKIN TRACTION (Non-Adhesive)

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5. Foam Traction – with same indication with Buck’s Extension;

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Modified Buck’s Extension Traction using commercially prepared foam.

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ON
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SPECIAL TRACTION
1. Boot Cast Traction – For patient with hip and
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knee contracture (ex. Post-polio with hip and

knee contracture).
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OF
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CAST
Things to remember:

✔ If the affected area is with open wound, infection and swelling – Cast to be applied should be molds and
splints only.
✔ If the affected area only has close type of fracture, no infection and swelling noted – Cast to be applied
should be circular.
✔ If the cast is with depression – it is indicated for patients with callus formation already.

3
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13. Delvit Cast – Modified PTB; with callus formation at the distal 3rd tibia/fibula to allow foot exercises
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OF
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5
 16. Cylinder Mold – For patella 17. Cylinder Cast – For patella
affection with open wound, affection.
infection and/or swelling.

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18. Knee Immobilizer – With same indication with cylinder mold using commercially prepared material to immobilize
affected leg

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 PY
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25. Frog Cast – For congenital his dislocation

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ON
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SPECIAL CAST
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BRACES

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DO
😜😜😜 END 😎😎😎
NIO
,D
ON
OT
CO
PY

10