- See: -
Forces Displacing the Fracture: -
Cast Brace:
- Discussion: - Caldwell (1933) - for displace frx of the humeral shaft with shortening, and also for oblique and spiral fractures;
- Indications: - used for comminuted humeral frx - disatl humeral shaft frx;
- Requirements: - cast must be light wt. and must extend from at least 1 inch proximal to the fracture site to wrist, w/ elbow at right angle & forearm in neutral rotation; -
arm must lie dependent to provide a traction force; - patient must sleep erect or semierect to avoid supporting elbow when seated; - erect position is maintained during the day as much as possible; - there should be no support under the elbow, and nothing should compress the arm against the body (such as clothing);
- Correction of Angulation: - sling must be securely fixed at the wrist by a loop made of plaster or other material; - to correct
lateral angulation, the loop is placed on dorsum of the wrist; -
medial angulation is corrected by placing loop on the volar side - anterior angulation may result from length of collar that is too long; - wrist drops below the horizontal plane, & distal fragment of humerus tilts posteriorly allowing anterior angulation of the fracture to result; - conversely a short collar and cuff will cause posterior bowing;
