Plaster Tips and Tricks

1. Plaster tips and
tricks
Samuel Duff
Orthopaedic Trainee

3. Why this talk?
• ED do Excellent MUAs
• Poor plaster results in early loss of position
• Once a molded plaster is on, it shouldn’t be changed
• Wrists and ankles

4. Common Pitfalls
• Wrong side plaster
• Too distal
• Thumb immobilised without indication
• What the heck is molding?
• Small plaster
• Too much velband
• Cylinder POP
• No Plaster education

6. Hand Creases

8. Molding

9. Cast index
• Ratio of Coronal to Sagittal width
of Plaster
• Ratio of <0.81
• Risk of need for re-
manipulation 26% vs 5%

11. What I do wrist
• 10 layers
• Biggest plaster for anyone over 10
• Cut long U in the middle
• Velband 1.5 layers with a bit extra for
styloid. Leave enough to fold back
• MC heads and distal palmar crease
• Smooth once on and wrap crepe
• Once starting to go warm mold
• Apply second bandage

12. Plaster Education
• Re-Wrap Daily
• Shouldn’t be painful
o Beware burning pain skin irritation / ulceration
• A good plaster wont necessarily be changed

13. Take home messages
• Don’t underestimate the pain relieving ability of
immobilisation / splinting
• Thin layer of velband
• 3 point molding
• Thin and wide vs a circle
• Review your own plasters on x-ray
• Come to Plaster clinic

14. Questions