Splint : Any material which is used to support a fracture is called a splint, e.g , folded newspaper , wood , cardboard , In the orthopaedic practice POP splint are most commonly. POP splint (plaster of paris): History :an accident to a house built on deposit of gypsum near the city of Paris ,burnt accidentally , rained on the next day , footprint of the people in the mud had set rock hard .Mathysen 1852 used in orthpaedics. Chemical formula :hemihydrated calcium suphate.

Various forms : Slab Casts Spica Rules of application of POP casts: Choose correct size :thigh(8 inches) , leg(6 inches) ,and forearm (4 inches) joint above and a joint below should be included It should be moulded with the palm and fingers Joints should be immobilised in functional positions Plaster should not be too tight or too loose Uniform thickness of the plaster is preferred.

COMPLICATION OF POP : Due to tight fit : - pain , - pressure sores , - compartmental syndromes , - peripheral nerve injuries Due to plaster allergy : - allergic dermatitis Due to improper application : - joint stiffness , - breakage , - plaster blister and sores.

TRACTION: Uses : to reduce a fracture or a dislocation To retain the fracture after reduction To overcome the muscle spasm To control movement of an injured part of the body and to aid in healing METHODS OF TRACTION : Skin traction :6.7 kg weight is used Skeletal traction : more than 5 kg Skeletal , pelvic and spinal.

Operative treatment : Implants : - defined as a material inserted or grafted into intact tissue or body cavity with some specific purpose. Plates : -widely used for internal fixation of diaphyseal fractures, - useful in subcutaneous situations , -prolonged immobilisation. Screw : -used mostly to fasten the plates to the bone, -used to fix fracture.

External fixation (EF) An EF is the method of fixing the fracture with a cluster of pins connected to external bars. Indication : -open fracture with severe soft tissue injury , - to stabilise long bone , - for fixation of pelvic fractures , - for definitive treatment of some fractures of the longs and pelvis Complication : - pin loosening , pin migration , pin breakage ,pin tract infection , -chronic osteomyelitis, septic arthritis

FACTORS AFFECTING FRACTURE HEALING: FACTOR FAVOURING UNION: Adequate circulation Hormones like GH , thyroxine etc. Good nutrition FACTORS DETRIMENTAL TO UNION: Poor circulation , infection segmental fracture osteoporosis inadequate and improper immobilisation