Humeral Brace Method
For the humerus fractures located in the humerus shaft (1a), the brace described hereafter can be applied; for more proximal fractures (1b), a long brace is applied, which is described later.
A stockinette is applied; to be sure that is stays wrinkle free, it is fastened around the neck (2). A sausage of stockinette is positioned underneath the stockinette from axilla to elbow, to ensure an overlap(3).
During the application, the arm should not be supported, eventually some traction is applied by an assistant (4).
The application starts distally with a circular turn, which includes the humeral condyles (5).
Be sure that no tension is applied to the roll during the application; the sausage should not be compressed (6).
With three to four circular windings the proximal border is reached; the entire biceps muscle must be included (7 & 8).
Another layer is applied with downwards windings (9).
At the distal border, the cast is fan-folded over the humeral condyles to strengthen the brace in this area with still a thin overlap (10 - 12).
A final circular turn distally completes the application. The remainder of the roll is not used as this would make the brace unnecessarily thick (13 - 14).
After the application a wet bandage is applied to guarantee a good lamination (15).
During setting the brace is properly molded to the humeral condyles (16).
The borders are marked with a pencil (17 & 18).
The cast can be opened with a scissor, alternatively a sharp knife is used to make the opening less painful (19).
Velcro straps or belts with buckles are applied; the borders are finished with Adheban. The brace is worn over a stockinette (20). The stockinette can be folded back over the tightened brace (21).
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