Application Technique Radial 2 Finger-Hand Cast

Indications:

  • Fractures of the 2nd and 3rd fingers.
  • Metacarpal 2 fractures.
  • Dislocations of the 2nd and 3rd fingers.
  • Tendopathy.
  • Capsule and ligament injuries.
  • Tendon injuries.
  • Soft tissue injuries.
  • Positioning splint.
  • Physio purposes.
Application: The materials should be pre-prepared to enable rapid application of the bandage. All the necessary materials should be placed within reach to avoid hold-ups in the procedure.

The patient should be in a position which is comfortable to him/her and the person applying the bandage. This may vary depending on the extent of the injury, the diagnosis, the treatment method and the patient's condition.

Materials required: 1 x 5 cm Delta Cast Conformable polyester support bandage and hydrogel-coated casting gloves, toweling tubular bandage, adhesive bandage, 2 cm wide strip of X-ray film, bandage scissors, felt-tip pen.

Photo 1:
The toweling tubular bandage is pulled over the finger, hand and wrist to form a layer of padding underneath. To help with the cutting a strip of unusable X-ray film is inserted on the ulna side beforehand. For more specific stability (e.g. in the case of repositioning) a 2-layer strip of cast is applied firmly around the palm.

Photo 2:
The cast is applied using circular movements (approximately 2 to 3 layers) around the finger, hand and wrist. The cast should be applied relatively tightly, extending it by 50% to 70%. This increases the bonding of the layers and improves the fit of the dressing. At the distal end, the cast should be applied to beyond the finger tips. This simplifies the later correction of joint positions.

Photo 3:
During the five to six minute molding phase the joint position can be corrected if required. Any folds occurring in the dressing can be smoothed out by pulling the surplus cast lengthwise at both ends.

Photo 4:
The cutting lines are marked with a felt-tip pen and the cast opened along the strip of X-ray film using bandage scissors. The cast is then trimmed for individual fit.

Photo 5:
Finished radial 2 finger hand cast including the wrist.

Photo 6:
The cast can be shortened at any time by trimming with bandage scissors to produce a radial 2 finger hand cast without inclusion thus allowing the wrist to function fully.

Photos 5 and 6 show the same cast but in photo 6 a large part has been cut from the cast. Both types can be held in place using adhesive bandages. (Not shown here). The small number of layers means that the cast remains semi-flexible and can be adjusted depending on the individual state of the swelling (looser or tighter). To do this, the adhesive bandage is removed and the cast altered for a perfect fit.

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Variant:

Radial 2-finger cast without wrist inclusion: Here the proximal part of the cast gets cut, so that the wrist retains its full function. (See also: Pict:6).

2-finger sandwich cast: Here the cast gets shortened proximal up to the finger base joints. This allows for an uninhibited movement of the wrist and the fingers in their base joints.

Middle-hand cast: The cast gets cut back distal up to the middle- or base joint of the fingers. This allows the finger movement.


All variants can get cut individually from the original cast, which got wound around all fingers !
The extent of the removal by cutting determines the grade of functionality or immobilisation !

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