Application Technique Radius / Forearm

Indications:

  • Fractures in the wrist near area.
  • Fractures in the carpal area.
  • Distorsion of the wrist.
  • Tendopathy.
  • Tendon and ligament 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 or 7.5 cm Delta Cast Conformable polyester support bandage and hydrogel-coated casting gloves, tubular bandage, Delta rol S padded bandage or toweling tubular bandage, self-adhesive fleece padding, adhesive bandage, bandage scissors, felt-tip pen.

Photo 1:
A tubular bandage which is twice the length of the forearm is applied and the special Delta rol S padded bandage is wrapped around it. This special, elastic padded bandage acts as a "Bandage for Compression of Soft Parts" under the cast. Alternatively, a toweling tubular bandage can be applied to form a layer of padding underneath. The self-adhesive fleece padding is applied as a thumb loop.

Photo 2:
The cast is applied and cut away in the area of the thumb using bandage scissors.

Photo 3:
The cast is wrapped around the hand and forearm using circular movements. For effective immobilization and in view of the expected swelling, the following layers should be applied: 2 layers in the distal area of the hand, 3-4 layers in the wrist area, 2 layers in the proximal forearm area. Complete accuracy is not required when applying the cast as it can easily be adjusted with bandage scissors.
In order to achieve the best fit and bonding of the layers, the cast should be applied relatively tightly (extending it by about 50% - 70% extension).

Photo 4:
The cast is molded to the hand, wrist and forearm area for approximately four to six minutes. The joint positions can be corrected. Any folds in the cast can easily be smoothed out by pulling both ends of the cast lengthwise. The cutting lines are then marked with felt-tip pen.

Photo 5:
The cast is then trimmed for individual fit using bandage scissors. A notch is cut into the cast away from the fracture, in order to prevent movement of the cut edges following re-application. If a cast has been applied too tightly it loosens by itself after cutting (special feature of Delta Cast Conformable). If necessary, the cast can be loosened by bending it open.

Photo 6:
The finished forearm cast is fixed in place with an adhesive bandage taking into account the state of the swelling. The overhanging tubular bandage is then pulled over the finished cast.

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. Re-application is carried out as described above. This procedure can be repeated throughout the duration of treatment.

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Variant:

Lower arm cast for the reduction of displaced radius fractures: The above mentioned lower arm is rather flexible, due to its number of layers, which could have a negative effect on the reduction result. By prior underlying the cast with a 4 - 6 layer thick dorso-volar cast-strip on the radial side the layer strength of the cast at the point of reduction gets up to 7 - 9 layers. In this way a localized rigid cast is created. After application and reduction the cast gets split on the ulnar-side To avoid the resulting automatic loosening of the cast it gets split in sections and immediately retaped. Thus a patientfriendly, flexible cast with localized around the fracture and reduction area is created.
The special advantages of the cast are getting obvious in the after-care.
It can be loosened or tightened fractionaly, which is especially important in the 1st week of treatment, because it can be adapted individually to the patient requirements (cast too tight), without jeopardizing the reduction result.

Wrist cuff: Here the lower arm cast gets shortened at the proximal end about a hands width above the wrist. The use of Hook & Loop strips eases the removal and refitting of the cast and the cast becomes just like the wrist-protectors for inline-skaters.

Lower arm brace: Through cutting (or directly at the application) a cast gets created, which does not impede the function of the wrist or elbow (see also: Tibia brace). The use of Hook & Loop strips eases the removal and refitting of the cast.

Wrist brace: Here an about handwide brace on the distal lower arm is created. The function of the wrist is not restricted. The use of Hook & Loop strips eases the removal and refitting of the cast.

Lower arm splint: Different variations with or without finger / hand inclusion. (See Inner forearm splint with finger support).

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