LOGIC March 2018 Vol 17 Vol 1 - Page 42

removed. Radiological union may lag behind clinical union, so if there is no soreness over the fracture then it is probably healed. A repeat x-ray can be undertaken four weeks after removal to check for callous formation. Rehabilitation Once the cast is removed, patients often find that the skin and muscle has been affected by the presence of the cast. Good cleansing and moisturising is required to return the skin to normal condition. Physiotherapy may be beneficial in order to achieve the best possible function in the hand. In some areas, patients can be referred to specialist hand physiotherapists for optimal treatment. This is the patient’s choice but the information gathered in the initial consult e.g. occupation, Figure 6: Scaphoid fracture dominant hand, hobbies, etc. will assist the healthcare provider to offer appropriate rehabilitation advice. Wheeless, C. R. (Ed) (2017) Wheeless’s Textbook of Orthopaedics. Retrieved from http://www.wheelessonline.co m/ References Wyllie, E. (2017) Managing common hand injuries: presentation at South GP CME 2017 Bone Shop Casting Materials: Synthetic V Plaster Plaster (Gypsona) – Will be applied to all new fractures or swollen limbs and also will be used for most re- manipulations. Most plaster casts will have a split after they have a post cast Xray to allow for swelling. Synthetic – We use 2 different products both come in a variety of colours and can be used alone or over plaster: Nemoa which is a plastic resin Delta light which is fibre glass Injuries more than a week old or with no swelling can go straight in to synthetic casts unless moulding of fracture is required. Synthetic casts are less dense on x-ray giving better views of the fracture. Synthetic casts can also be applied with waterproof lining and no padding. March 2018 L.O.G.I.C 40