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Orthopaedic Presentation




PLASTER OF PARIS (POP)
            By:
  Muhammad Syafiq Hilmi Musa
   Ahmad Soufi Ahmad Fuad
What is Plaster of Paris?


    Plaster – basic building material for coating
    walls and ceilings.

    Starts as a dry powder, harden when applied
    together with water and heat.

    Different type –
        −   Plaster of Paris (Gypsum)
        −   Lime plaster
        −   Cement plaster

    Different type use in different setting. As in
    architecture, art, fire protection and even in
    medicine.

    Plaster of Paris is widely used in Medical
    setting espescially in Orthopaedic department.

    POP results from the calcination of gypsum or
    calcium sulfate dihydrate (CaSO4, 2 H2O),
    which partially dehydrates to produce a hemi-
    hydrate (CaSO4 , ½ H2O).
History

- The term plaster of Paris was first used in the 17 th
   century due to large quarry deposits of gypsum located
   in Montmartre, a district of Paris. They mostly use them
   for sculpturing, decoration and surface for painting.
- But researcher has found plaster wall and artifacts for
   interior of Great Pyramids. This prove usage of plaster
   has been since ancient times.
- Invention of plaster bandage can be attributed to Arabic
   doctor in 1000 C.E. (Al-Tasrif). But POP bandages
   were first used by Matthysen, a Dutch military surgeon
   in 1952.
Indication of Plaster Usage

1) Chronically stiff joint.
2) Hard end feel contractions of any joint.
  Secondary to:
  - fracture, amputation, tendon rupture, lacerations or
     repair, nerve repairs and burns
3) Deformity.
Plaster Type

1) Plaster of Paris (POP)
  - Roll of muslin stiffened by dextrose or starch and
    impregnated with hemihydrate calcium sulfate.
  - It is cost-effective, non allergic and easy to mould.
  - But it is heavy and fragile if contact with water.
2) Fibreglass
  - Strong but lighter than Plaster of Paris.
  - It is cool, water resistant and radiolucent.
  - But it is more expensive.
Cast Application
- Clean skin and apply dressing if there is wounds. Apply
  uniform thickness of cotton padding
- Soak plaster roll in water at room temperature
- Gently pick up the ends of the bandage with both hands
  and lightly squeeze it, pushing the ends together
  without twisting or wringing
- Hold relevant body part steady in correct position
- Apply the plaster by unrolling the bandage as it rests
  on the limb. Overlap the previous layer of plaster by
  about half the width of the roll
- Mould the plaster evenly, rapidly and without
  intervention. Rubs each layer firmly with the palm so
  that the plaster forms a mass.
- Mould until firm and let it completely dry for 24 hours.
- Same methods goes with fibreglass type plaster.
- For removal, we can use plaster shears or electric saw.
Types of Cast

1) Bivalved - Can be removed, secured with
  Velcro
2) Drop out cast - part of the extremity can be
  moved
3) Cylindrical cast - typical fracture cast
4) Weight bearing casts - to hold extremity in
  position to assist in weight bearing
Short leg patella
                                        tendon bearing cast
                 Typical Cast



                    Long arm cast
Minerva jacket




Cylinder cast                        Short arm thumb spica cast
                    Hip spica cast
Complications
Due to tight cast:
                                Due to improper
- Pain
                                application:
- Pressure sore
                                - Joint stiffness
- Compartment
                                - Blisters and sores
syndrome
                                - Breakage
- Peripheral nerve injury




                               Others:
 Due to plaster allergy:
                               - Deep vein trombosis
 - Allergic dermatitis
                               (DVT)
Advice to patients

- Do not get the cast wet. Use plastic bags to
  cover the cast while bathing.
- Do not walk on the cast.
- Do not stick anything down to the splint to
  scratch or itch. This may lead injury and
  infection.
- Instruct patient to return if there is numbness,
   tingling, increase pain and impaired sensation.
THE END.
THANK YOU

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Plaster of Paris

  • 1. Orthopaedic Presentation PLASTER OF PARIS (POP) By: Muhammad Syafiq Hilmi Musa Ahmad Soufi Ahmad Fuad
  • 2. What is Plaster of Paris?  Plaster – basic building material for coating walls and ceilings.  Starts as a dry powder, harden when applied together with water and heat.  Different type – − Plaster of Paris (Gypsum) − Lime plaster − Cement plaster
  • 3. Different type use in different setting. As in architecture, art, fire protection and even in medicine.  Plaster of Paris is widely used in Medical setting espescially in Orthopaedic department.  POP results from the calcination of gypsum or calcium sulfate dihydrate (CaSO4, 2 H2O), which partially dehydrates to produce a hemi- hydrate (CaSO4 , ½ H2O).
  • 4. History - The term plaster of Paris was first used in the 17 th century due to large quarry deposits of gypsum located in Montmartre, a district of Paris. They mostly use them for sculpturing, decoration and surface for painting. - But researcher has found plaster wall and artifacts for interior of Great Pyramids. This prove usage of plaster has been since ancient times. - Invention of plaster bandage can be attributed to Arabic doctor in 1000 C.E. (Al-Tasrif). But POP bandages were first used by Matthysen, a Dutch military surgeon in 1952.
  • 5. Indication of Plaster Usage 1) Chronically stiff joint. 2) Hard end feel contractions of any joint. Secondary to: - fracture, amputation, tendon rupture, lacerations or repair, nerve repairs and burns 3) Deformity.
  • 6. Plaster Type 1) Plaster of Paris (POP) - Roll of muslin stiffened by dextrose or starch and impregnated with hemihydrate calcium sulfate. - It is cost-effective, non allergic and easy to mould. - But it is heavy and fragile if contact with water. 2) Fibreglass - Strong but lighter than Plaster of Paris. - It is cool, water resistant and radiolucent. - But it is more expensive.
  • 7. Cast Application - Clean skin and apply dressing if there is wounds. Apply uniform thickness of cotton padding - Soak plaster roll in water at room temperature - Gently pick up the ends of the bandage with both hands and lightly squeeze it, pushing the ends together without twisting or wringing
  • 8. - Hold relevant body part steady in correct position - Apply the plaster by unrolling the bandage as it rests on the limb. Overlap the previous layer of plaster by about half the width of the roll - Mould the plaster evenly, rapidly and without intervention. Rubs each layer firmly with the palm so that the plaster forms a mass. - Mould until firm and let it completely dry for 24 hours. - Same methods goes with fibreglass type plaster. - For removal, we can use plaster shears or electric saw.
  • 9.
  • 10. Types of Cast 1) Bivalved - Can be removed, secured with Velcro 2) Drop out cast - part of the extremity can be moved 3) Cylindrical cast - typical fracture cast 4) Weight bearing casts - to hold extremity in position to assist in weight bearing
  • 11. Short leg patella tendon bearing cast Typical Cast Long arm cast Minerva jacket Cylinder cast Short arm thumb spica cast Hip spica cast
  • 12. Complications Due to tight cast: Due to improper - Pain application: - Pressure sore - Joint stiffness - Compartment - Blisters and sores syndrome - Breakage - Peripheral nerve injury Others: Due to plaster allergy: - Deep vein trombosis - Allergic dermatitis (DVT)
  • 13. Advice to patients - Do not get the cast wet. Use plastic bags to cover the cast while bathing. - Do not walk on the cast. - Do not stick anything down to the splint to scratch or itch. This may lead injury and infection. - Instruct patient to return if there is numbness, tingling, increase pain and impaired sensation.