Plasterof Paris forearm aplication

Application of Below Elbow POP Slab

•   This type of slab is often used where short term immobili­zation is required, and where swelling is anticipated.

•   It is very useful where pain relief is the main reason for immobilization. Perhaps most commonly used in the treatment of a Colles fracture. Slab should be held at the two ends and drawn slowly through the water. It can then be held vertically by one end and the water allowed to drain off (Fig. 23.3).

•   Finally, the slab is allowed to collapse into the palm of the hand and is gently compressed to remove surplus water.

•   It is then spread out on a flat surface and air bubbles are squeezed out with the palm of the hand.

•   It is an important point in plaster technique that the layers should be well bonded together without air bubbles and dry areas otherwise the strength of the plaster will be adversely affected. If required, the plaster slab can be stren­gthened by drowning the wet plaster up into longitudinal ridges, taking care to avoid irregularities on the inner surface.

•   Counter traction is neces­sary when manipulating a fracture. A plaster slab is prepared from a 15 cm wide plaster bandage.

•   The arm is measured from the tip of the olecranon to the knuckles and the slab is arranged to be 5 cm longer than this measure­ment.

•   If required, the slab can be slightly wider at the elbow.

•   The slab is applied over a layer of well-fitting stockinet of over a single layer of plaster wool applied as a bandage.

•   Use a simple sling for this purpose.

•   A traction band is passed around the upper arm over a pad of wool and is fixed to a wall hook or other immovable object.

•   The fingers are then grasped by an assistant and the arm and hand are left completely free to allow application of the plaster.

•   If a Colles fracture has been manipulated, the correct position for the wrist can readily be achieved by applying traction to the thumb with the latterin line with the forearm. This gives the necessary degree of ulnar alignment.

•   The slab is laid along the dorsum of the forearm, wrist and hand and is moulded carefully to the limb.

•   The slab is bandaged on with a wet gauze bandage, care being taken not to pull this tightly.

•   Finally, the ends of the slab are folded back obliquely to leave a neat finish and to avoid restricting elbow and finger movements.

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