LOGIC March 2018 Vol 17 Vol 1 - Page 41

without compromising other joints. Figure 4: Unar Collateral Ligament avulsion: Bennets fracture In some cases, adaption of any of the above casts may be necessary to ensure good reduction and immobilisation of the fracture, e.g. patients with dementia are unable to understand why they have a cast so an above elbow cast may be applied in place of a shorter cast to make it more difficult for th em to remove. After Care Figure 5: Base of 1 st MC fracture a wrist splint, if not too sore, or a cast, with repeat x-ray and examination at 10 – 14 days to confirm or deny a fracture. Because of the very poor blood supply to the area, scaphoid fractures require up to 12 weeks in a cast. Even then, scaphoid non-union can occur. March 2018 L.O.G.I.C Wrist Splints Minor avulsions from other carpal bones can be treated in a wrist splint for comfort. Velcro wrist and thumb splints come in several sizes and can be used for either side. Thumb splints can also be useful for minor sprains Hand casts remain on for a maximum of 4 weeks, with the exception of the scaphoid fractures (see above). Patients are advised on how to care for their cast. The Bone Shop x-ray weekly until callous forms because the fracture can slip as swelling goes down and the cast gets looser. If a fracture slips in the first 3 weeks it can be successfully re-manipulated but after 3 weeks the callous makes the fracture sticky and less likely to slip so no further x-rays are needed until the cast is 39