Complication Pop 44h4w

COMPLICATION OF POP

SYSTEMIC COMPLICATIONS DVT LEADING TO PE IMMOBILISATION IN TRUNK PLASTERNAUSEA, ABDOMINAL CRAMPS, URINARY RETENTION, ABDOMINAL DISTENSION

TIGHT CAST -D/T PUT ON TIGHTLY OR BECOME TIGHT IF LIMB SWELLS -℅ DIFFUSE PAIN, OR SIGNS OF VASCULAR COMPRESSION(PALE, LOSS OF POWER) -NEED TO SPLIT CAST(OR BIVALVE) AND ELEVATE LIMB -WHENEVER EXPECT SWELLING, CAST TO BE APPLIED OVER THICK PADDING AND PLASTER SPLIT BEFORE IT SETS -PAIN , COMPARTMENT SYNDROME, PERIPHERAL NERVE INJURY

PAIN tissue damage at injury or reduction swelling within the cast muscle spasm pressure on blood vessels or nerves skin irritation or sores.

DELAYED COMPLICATIONS PRESSURE SORE LOSS OF POSITION NERVE INJURY

PRESSURE SORES -WELL FITTING CAST MAY PRESS UPON SKIN OVER BONY PROMINENCE(PATELLA, HEEL, ELBOW, OR HEAD OF ULNA) -COMPLAINTS OF LOCALISED PAIN NEEDS IMMEDIATE INSPECTION THROUGH A WINDOW CAST

SIGNS -BURNING, ITCHING, STABBING PAIN -HEAT AND SWELLING OF DIGITS -INCREASED WARMTN OVER A LOCALISED AREA OF THE CAST -VISIBLE PUS OR STAINING OF THE CAST

WHY? ●

Poor technique with adequate padding, or a ridge inside the cast, or failure to trim the ends of the cast correctly.

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Local cast breakdown with skin irritation due to poor care

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Foreign bodies may easily slip between the cast and the skin. Children especially may insert small toys, coins or beads while hairgrips may fall inside the cast.

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Patients should be warned of these damages and also to care for the plaster edges since wetting will cause plaster crumbs to be detached and fall inside the cast.

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Scratching at minor irritation beneath the cast with metal implements or knitting needles may cause trauma and infection. Such irritation should be reported and investigated early.

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Plaster soakage leading to skin damage and infection

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Cut edges of plaster following splinting or bivalving or window procedures may irritate the skin especially if swelling occurs around the edge.

Grades of Sore Sores are graded according to depth of the involvement. ● Grade I-Redness of skin ● Grade II-Involvement of Subcutaneous Tissue or cellulitis ● Grade III- Involvement of Muscles ● Grade IV- Bone Deep

LOSS OF POSITION swelling occur with most fractures especially after reduction the technician puts padding under the cast to protect the skin This padding gets compressed After 48 hours when the oedema is subsiding, the cast may be too loose to hold the bone ends in position against undesirable muscle action. Such displacement may be sudden and cause pain or gradual being first noticed on the next x-ray This complication may seriously delay sound healing and may produce permanent deformity.

NERVE DAMAGE Loss of power, tingling and numbness distal to the cast The cause may be direct compression by bone ends or plaster pressure, indirect compression of oedematous tissue or tourniquet effect, or reduced blood flow. Routine testing of power and sensation will detect any defect quickly. Corrective action includes relieving cast pressure, ing and protecting paralyzed parts, and physiotherapy to help restore normal function of muscle and ts.

SKIN ABRASION OR LACERATION -COMPLICATION WHILE REMOVING PLASTERS -COMPLAINTS OF PINCHING OR NIPPING

IMPROPER APPLICATION T STIFFNESS BLISTERS AND SORES BREAKAGE

LOOSE CAST -ONCE SWELLING SUBSIDES, NEED TO BE REPLACED

ALLERGIC DERMATITIS

AVOID COMPLICATION ❏ Application of the plaster cast should be done by a skilled person in proper manner ❏ Strict elevation of the limb should be instructed. ❏ Patient should report on pain that is not relieved, swelling, bluishness or pallor of distal part. ❏ Patient should be carefully examined in the follow up for probable complications of plaster cast