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and

Fixators



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rigid

device

Splint



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qis a

device

Uses



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Types:1. Hand and Finger Splints

For relief from arthritis, carpal

tunnel, after injury or surgery,

or for the correction of physical

deformity, hand and fingersplints are availab

le to hold the

hand, wrist or fingers in a

position that will allow

maximum healing and ease of

pain.



3/13/122. Le S lints



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http://slidepdf.com/reader/full/copy-of-hermin-rocks 7/453/13/12

. ac p n s

Back

splints or

supportsare

available

for

posture

correction



4. Splints for Headaches and Dental Problems

Den

tal

spli



Taking care of splint

• Do not get the splint wet. Use

plastic bags to cover the splint

while bathing.

• Do not walk on the splint

• Do not stick anything down the

splint such as a coat hanger to

scratch or itch. This may lead to



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Minimize swelling

• Rest, Ice, and Elevate

• Ice-apply to area where there is no

plaster for no more than 15-20 minutes

at a time

– Longer may numb the extremity

– shorter may not affect swelling

– May use an ice bag with a wet



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Minimizing pain• Apply ice to injured

extremity for 15-20

minutes of each hour for

1-2 days. May use ice inzip lock bags or bags of

frozen peas.

• Give acetaminophen

(Tylenol) or ibuprofen



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• If the injury

involves an arm, it

should be placed in

sling and kept at or

above the level of the

heart for 24 hours to

limit swelling.

• If the injury



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e s o ex rem y assessment

Pain:Palpate theentireextremity for

increase pain

Pallor:Note color andtemperatureand capillary

refill

Pulses:Palpateproximal anddistal pulses

Paresthesia:

Assess forburning,tingling,numbness

Paralysis:

Assess motorfunction (bothactive andpassive

Pressure:

Palpate forfirmness of compartment



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Danger signs:

Numbness

Tingling

increased pain

change in coloration of fingers or toes

swelling in fingers or toes



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Complications:

Abrasions

Sores

Neurovascular compromise

(tight fitting splints)

Contact dermatitis

Pressure ulcers

Thermal burns

PROBLEM POSSIBLE CAUSES WHAT TO DO



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PROBLEM POSSIBLE CAUSES WHAT TO DO

Skin irritation,red areas,blisters

· Pressure due tosplintfitting incorrectly· Splint appliedincorrectly· Poor sensation

· Remove splint· Contact yourOccupationalTherapist· Review how toapplythe splint· Review wearingregime

Increase inswelling

· Straps fastened tootightly· Improperpositioning of arm/hand

· Loosen straps· Review how toapplythe splint· Keep arms

supportedPain · Splint/straps

appliedincorrectly

· Review wearingregime· Consult yourOccupational

Therapist· Keep arms



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FIXATORS

A device composed of rods

and

pins designed to provide stabilization of

a body part.



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A. External Fixations

Definition:

A surgical treatment used to set bone

fractures in which a cast would not allow

proper alignment of the fracture.

External Fixators - An apparatus

consisting of a rigid frame that connects

pins passed through the skin into the

bone above and below the fracture



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Uses:

Provides stable support for severely

crushed or splintered fractures while

permitting active treatment of damaged soft tissues

Used particularly to treat somecompound fractures

Also used for limb lengthening



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Nursing Interventions:

Prepare the patient psychologically

Elevate the extremity after the fixator isapplied

Sharp points of the fixators or pins should

be covered with cork or tapeMonitor neurovascular status of the

extremity every 2-4 hours

Assess each pin site for redness,tenderness, pain and loosening of the pin

The nurse must be alert for potential

problem cause by pressure from the



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q Nurse carries out pin care as specified

q Nurse notifies the physician if there’s a sign

for infections

q Encourage isometric and active exercises as

tolerated

q When the swelling subsides, the nurse helps

the patient become mobile with in theprescribed weight – then bearing limits

q Fixator is removed after soft tissues heals



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X-ray picture of an externalfixator



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External fixators to correct club foot



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External fixator at the lower extremity



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B. Internal fixation

Definition:

An operation in orthopedics that

involves the surgical implementation of

implants for the purpose of repairing a

bone. An internal fixator may be made of

stainless steel or titanium.

Fixation of screws and/or plates, intra-

medullary bone nails (femur, tibia,

http://en.wikipedia.org/wiki/Surgery

http://en.wikipedia.org/wiki/Orthopedics

http://en.wikipedia.org/wiki/Implant_(medicine)

http://en.wikipedia.org/wiki/Bone

http://en.wikipedia.org/wiki/Stainless_steel

http://en.wikipedia.org/wiki/Titanium

http://en.wikipedia.org/wiki/Femur

http://en.wikipedia.org/wiki/Tibia

http://en.wikipedia.org/wiki/Tibia

http://en.wikipedia.org/wiki/Femur

http://en.wikipedia.org/wiki/Titanium

http://en.wikipedia.org/wiki/Stainless_steel


http://en.wikipedia.org/wiki/Implant_(medicine)

http://en.wikipedia.org/wiki/Orthopedics

http://en.wikipedia.org/wiki/Surgery



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An internal fixation device may be used to keepfractured bones stabilized and in alignment. The

device is inserted surgically to ensure the bonesremain in an optimal position during and after the



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Types of internal fixations:

A. Open Reduction InternalFixation (ORIF)

Involves the implementation of implants

to guide the healing process of a bone, as

well as the open reduction, or setting, of

the bone itself.

Refers to open surgery to set bones,

as is necessary for some fractures.

http://en.wikipedia.org/wiki/Fracture

http://en.wikipedia.org/wiki/Open_surgery





http://en.wikipedia.org/wiki/Open_surgery



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Rigid fixation prevents micro-

motion across lines of fracture toenable healing and prevent

infection, which happens whenimplants such as plates (e.g.

dynamic compression plate) areused.

Often used in cases involving

http://en.wikipedia.org/wiki/Dynamic_compression_plate






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Risks and complications:

include bacterial colonization of the bone,

infection,

stiffness and loss of range of motion, non-

union (improper healing), mal-union

(healing in improper position), damage to

the muscles, nerve damage and palsy,arthritis, tendonitis, chronic pain

associated with plates, screws, and pins,

com artment s ndrome, deformit ,

Cl d d i l

http://en.wikipedia.org/wiki/Deformity

http://en.wikipedia.org/wiki/Infection

http://en.wikipedia.org/wiki/Joint_stiffness

http://en.wikipedia.org/wiki/Arthritis

http://en.wikipedia.org/wiki/Tendonitis

http://en.wikipedia.org/wiki/Pain

http://en.wikipedia.org/wiki/Compartment_syndrome



http://en.wikipedia.org/wiki/Compartment_syndrome

http://en.wikipedia.org/wiki/Pain

http://en.wikipedia.org/wiki/Tendonitis

http://en.wikipedia.org/wiki/Arthritis

http://en.wikipedia.org/wiki/Joint_stiffness

http://en.wikipedia.org/wiki/Infection



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B. Closed Reduction Internal

Fixation (CRIF)

Reduction without any open surgery,

followed by internal fixation

Alternative in unstable displaced lateral

condylar fractures of the humerus in

children, but if fracture displacement afterclosed reduction exceeds 2 mm, open

reduction and internal fixation is

Common types of internal

http://en.wikipedia.org/wiki/Reduction_(orthopedic_surgery)

http://en.wikipedia.org/w/index.php?title=Condylar_fracture&action=edit&redlink=1


http://en.wikipedia.org/wiki/Humerus

http://en.wikipedia.org/wiki/Humerus



http://en.wikipedia.org/wiki/Reduction_(orthopedic_surgery)



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Common types of internalfixators:

1. Wires

Wires are often used as sutures or threads

to "sew" the bones back together.

Can be used in conjunction with other

forms of internal fixation to hold bones

together.

Can be used alone to treat fractures of



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2. Pins

Pins hold pieces of bone together. They

are usually used in pieces of bone that

are too small to be fixed with screws.

These pins are usually removed after a

certain amount of time, but may be left in

permanently for some fractures.

3 Pl



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3.Plates

Plates are like internal splints that hold

the fractured ends of bone together.

Extend along the bone and are screwed

in place. If two bones that run parallel to

each other both break, such as in the

lower leg, plating one bone may provide

enough support for the other bone as

well.



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4. Nails or Rods

In some fractures of the long bones, the

best way to align the bone ends is by

inserting a rod or nail through the hollow

center of the bone that normally contains

some marrow.

• Held in place by screws until the fracture

has healed.

•May be left in the bone after healing is



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5. Screws

Bone screws are used for internal fixationmore often than any other type of

implant. Although the bone screw is a

simple device, there are several designs

based on how the screw will be used.

Can be used alone to hold a fracture, as

well as with plates, rods, or nails.

May be designed for a specific type of



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