For immobilizing the joint, a plaster should be adequate enough to counter the forces of the muscles that move the joint. Keep the genital area as clean and dry as possible to prevent skin irritation. Soft resilient material such as wool felt and special orthopedic padding is placed on the skin before plater application. There are seven tarsal bones. Slabs can be prepared by unrolling plaster bandage to a required length or by withdrawing the required length of layers from a plaster dispenser. Distal extent is up to metatarsophalngeal joints and proximally it covers lower two-thirds of the thigh. Move the fingers and toes below the cast. Above elbow cast. It has been reformatted for general medical education by the Brookside Associates. straumann.ca. However, if a very rapid set is required soaking the bandage in warm water will accelerate the rate of reaction. If it is difficult to move the fingers or toes, see the doctor immediately. It is an extended clinical skill requiring sound knowledge, not only in the process of application, limb positioning but also the fundamentals musculoskeletal physiology. The cast does not fully dry out until 36 to 72 hours after application. A temporary measure of pain relief and reduction of swelling so that definitive treatment could be executed. Movement of the plaster, while it is setting, will cause gross weakening. Plaster shears are available at medical supply companies. Simple application of a plaster of Paris (POP) or fiberglass cast is performed without sedation in older children and in compliant younger children. The cast must be worn until the fractured bone has knit itself together and the affected limb can bear weight. Arun Pal Singh is an orthopedic and trauma surgeon, founder and chief editor of this website. It covers full parts with the plaster to enhance the immobilization. Elevate the cast above the level of the heart to decrease swelling and move the fingers or toes to promote circulation. For securing, each turn is overlapped by one third in order to secure layers. however, knowledge, application of a plaster of paris cast alamy. REGARDING PREPARATION OF CLIENT AND THE ARTICLES 1. A plaster cast is a circumferential application of plaster bandages. This is a frequently used circumferential immobilization cast of the forearm and wrist made of either synthetic material or plaster of Paris, used as a treatment for some local fractures and soft tissue injuries. Orthopedics is just one of many specialties offered by Summit Medical Group. The management involves control of symptoms by various modalities. Plaster can be applied for a temporary period while waiting for definitive treatment or it could be definitive treatment in itself. The bandage is removed by holding it at the ends. An unpadded cast has the danger of swelling which is less with padded casts as the padding buffers the space needed for the swollen tissue. It cheaper in comparison with more modern materials. This can usually be relieved by lying down and elevating the arm or leg on one or more pillows and by constantly moving those joints of the arm and leg that are not covered by plaster. The setting time is three times longer at 5 degree Celsius (40 degrees F) than at 50 degree Celsius (125 degrees F). The cast does not fully dry out until 36 to 72 hours after application. It is important in weight bearing casts of walking casts and the patient should be instructed accordingly. This video was originally produced by the US Army in 1968 as a training aid for their medical personnel. 2 Introduction Basic Principles of Fracture Treatment: Reduce (Reduction) Hold (Immobilization) Plaster Cast Exercise (Rehabilitation) 3 Different Types of Plaster •Plaster Bandage: Plaster of Paris (POP) •Resin Bandage . The plaster may feel tight for some time after application. You can follow him on Facebook, Linkedin and Twitter, Your email address will not be published. Plaster cast application is not the end of the treatment. The absorption of water while setting gives out heat (an exothermic reaction). CAST APPLICATION To prepare plaster of Paris bandage, use dry cotton gauze (muslin) bandage, 500 cm long and 15 cm wide. Learn how your comment data is processed. Sometimes, two slabs may be applied, for example, one anterior and second posterior, for better strength and control. It is also called Jumper’s knee. The responsibility of the nurses lies in the preparation of the client, the articles, helping the doctor in an application of the plaster cast, after care of the client and the articles. Applications Linguee . To learn about all we have to offer, please contact us at the number below or visit our corporate site. Most of the closed reductions of the fractures require a cast application. Plaster casts used to be more common Until the 1970s, the most common type of cast was made with plaster of paris. Prevent small toys or objects from being put inside the cast. Plaster of Paris casts are frequently used to put casts in fracture patients. Next Post → Leave a Comment Cancel Reply. • For this procedure cast/slab can be made from POP or fiber glass can be used. For immobilization of joints in case of ligament injury, joint swelling due to disease. The ends are gently squeezed towards the center then pulled back to shape. Your email address will not be published. The cause of condition is poorly understood and there is no cure. When it’s time for the cast to be removed, the doctor will use a cast saw to cut it off. Bennett’s cast . A definitive treatment where plaster is applied to maintain the reduction of the fragments. Slabs are applied in a case where there is swelling, poor skin condition that needs to be observed like blisters, after internal fixation to aid the fixation, while waiting for definitive treatment. The affected part should be covered with suitable padding and the desired position secured and held correctly. Immersion in water initiates an exothermic reaction in the plaster causing it to harden. Removal of the cast is also difficult and uncomfortable for the patient. These are. Adding water allows for a return to the original crystalline state of full hydration. This may be done with either wet or dry bandages which are folded out on a smooth surface. It is a noninvasive option for immobilizing a broken bone. Forearm casts are particularly prone to getting wet at the lower edge which may fray. You must have seen those white colored casts, those are made of plaster of Paris or POP. It is normal for swelling to increase in the first few days after a cast goes on. The short arm cast is also known as the below-elbow cast . Plaster of Paris, in its raw state, is termed gypsum hydrated calcium sulfate with impurities. Short ends should be discarded because they cannot be held securely when the slab is immersed in water. Sitting in sunlight or in where the air is circulating adequately would hasten the drying time. Plaster of Paris Plaster is the most commonly used casting material because of its ease of use. For example, if spinal injury signs are […], True and apparent leg length refer to limb lengths in absolute terms and in compensated forms. Whether fiberglass or plaster, cast application is performed the same way. Show More Information on the Application of Plaster Casts. The cast is also difficult to split and bivalve. The distal row contains, from medial to lateral side, medial cuneiform, the intermediate cuneiform, the lateral cuneiform and the cuboid. The patient should be instructed not to wet, cut, heat or otherwise interfere with the plaster. Elevate the affected limb above the heart. Plaster and fiberglass harden into a tight, stiff encasement that prevents the fractured area from moving and allows the broken ends of the bone to heal together. Ambulation with casts may require assistive devices. Clean the skin and apply dressings to any wounds. The essential chemical step is the heating of gypsum to 120 degree Celsius (250 degree F). {Wetting does not affect the fiberglass cast per se, but even in these cases, water may percolate to the padding where it would affect the skin. Orthopedic health, conditions and treatment. All the casts in case of acute fractures should be recalled the next day to note any discomfort, bluishness, swelling and numbness of the digits. If you’d like to request an appointment, follow the link below and answer a few short questions. This involves mixing white powder with water to form a thick paste. A video describing the application of plaster of Paris cast is shown below. Pad the rough edges to protect the skin from scratches. The cast is too loose or too tight; a tight cast may feel better with a period of elevation of the affected limb, There is new tingling or numbness, or poor circulation (cold, numbness, very dark or very white) in the affected fingers or toes. Severe itchiness, wetness, discharge and heat under the cast may indicate an allergic reaction (Larsen 2002). Someone will get back to you as soon as possible. External splint for blocking movements in case of nerve, tendon or vessel repair. Application of cast 1. Traductions en contexte de "plaster cast" en anglais-français avec Reverso Context : (Pierre) We should have made a plaster cast. These must be removed regularly to prevent the plaster from becoming damp as sweat fails to evaporate. Post navigation ← Previous Post. The patient should be instructed to move the fingers or toes of the affected limb. Canvas or plastic coverings may be used for short periods to protect the cast from water. At home, the patient must be advised not to rest the wet cast on a firm surface such as an unpadded chair. An application of a plaster cast is entirely a responsibility of doctor. Rule of thumb for plaster applications block a joint above and below the fracture. "application of plaster cast": examples and translations in context Some of the wounded whose bone fractures had been documented by X-rays were discharged from the hospital without receiving medical treatment (such as the application of plaster casts ), and were not treated until several days later at other medical facilities. If the injury is recognized, steps can be taken to undo the process that might have caused it. Plaster Cast Care Author: Royal Brisbane and Women s Hospital, Occupational Therapy Subject: Plaster Cast Care Keywords: Royal Brisbane and Women’s Hospital, Occupational Therapy, RBWH, Occupational Therapist, hands,plaster care, cast, care of cast, wearing instructions Created Date: 7/4/2017 8:56:44 AM It means partial or complete congenital fusion between the atlas and the base of the occiput. Certain types of fractures, such as hip fractures, are known to heal poorly or with increased risk of complications without surgery, so a cast is usually inappropriate for those cases as well. Plaster Cast Market: Global Growth Manufacturers, Regions, Product Types, Major Application Analysis & Forecast to 2026 Market Study Report Date: 2020-10-25 Business Product ID: 2908780 A cast is used to hold a fractured bone in place while it heals. Bandages of the correct size are immersed in water, one at a time, and held there until bubbling stops. Though few people had advocated this in the past, a plaster cast or slab is not applied without the padding. Spica casts need special care especially using bedpan or urinal. Minimum tension should be exercised and this should be directed towards the center of the bandage-not at the edges. Do pull support or lift the person by cast or bar on the cast. If you are seeking care for a fracture, follow the link below and answer a few short questions. For lower limb injuries, the limb is placed on a cushion or pillow. Stagnara wake up test aims at recognizing early intraoperative warning of potential damage. Rasp in Orthopedic surgery. For the first twenty-four hours keep the limb raised as much as possible. Molding of the bandages to the contours of the limb should be done by constant smoothing with the palms of the wet hands. An orthopedic cast, or simply cast, is a shell, frequently made from plaster or fiberglass, that encases a limb (or, in some cases, large portions of the body) to stabilize and hold anatomical structures—most often a broken bone (or bones), in place until healing is confirmed. *. A plaster cast, slab or splint is applied in broken bones of upper or lower extremity. When a dry plaster of Paris cast is tapped with the knuckles, it gives a crisp, clear sound, but the damp cast gives a dull sound. Sometimes a slab is used for initial immobilization and is completed later. For details of the procedure, please click on the relevant link. application of backslab cast, & administer as per medication policy. When there is a shortening of the limb, the body compensates by tilting the pelvis down, equinus position of the foot and flexion of the opposite […], Hip pain is the broad term that denotes the pain in the hip joint and nearby structures. The basic aim of a plaster application is … Plaster Cast Application Plaster casts are frequently used to hold your limb in the correct position to allow the bones to heal following your injury. The hip joint is a ball and socket joint and is involved in the day to day activities of load bearing. Both of these layers act as a buffer between the skin and the cast to reduce irritation. … [Read More...] about Lysholm Knee Scoring Scale. The slab can be prepared in any width, depending on the needs of the situation. Once applied, it will feel hard within 4 minutes, however, it takes 2-3 days to dry completely. Application of Plaster Casts. In some cases–if the bone is badly misaligned, sticking through the skin or broken into three or more pieces–surgery is necessary to realign the bone. When a dry cast is tapped with the knuckles, it gives a crisp, clear sound, but the damp cast gives a dull sound. Because plaster of Paris is infinitely mouldable in the wet state it can be set around cast brace hinges and walking heels with ease. Do not bear any weight on the cast unless specifically instructed by a doctor. Whether fiberglass or plaster, cast application is performed the same way. This will reduce swelling and fluid buildup. This encourages the return of the blood due to pumping of blood by muscles and also in the reduction of swelling. Tips to keep body casts clean and dry and prevent skin irritation around the genital area include the following: Use a diaper or sanitary napkin around the genital area to prevent leakage or splashing of urine. First, a loosely knitted piece of fabric called a stockinette is placed over the fracture area. Examples of injuries for Although Plaster of Paris only depends on one simple chemical reaction for its setting, it is possible to vary the features of the process according to different requirements. The environment should be one in which the child and the parents/carers are comfortable. Care of plaster cast is very necessary. Trauma Management with Cast Application AADO Dr K B Lee Queen Elizabeth Hospital 3 Nov 2013 . Removing a plaster cast requires having access to either plaster shears or an electric cutter. Instead one can use a hairdryer placed on a cool setting to blow air under the cast and cool down the hot, itchy skin. All patients need to be given instructions about how to take care of plaster cast and preferably in writing. Patellar Tendinosis Symptoms and Treatment. Cast application . Patellar tendinosis is found in sportsperson who play sports that involve jumping and heavy landing, rapid acceleration or deceleration and kicking, such as basketball, volleyball, soccer, tennis, long jump, and high […], Atlanto-occipital fusion or Occipitalization of atlas [C1]is the most common congenital abnormality of the upper cervical spine. The forearm bones (radius and ulna) are the two most commonly broken bones in the body.1 Immediate management of these injuries includes applying a plaster cast—called a back slab—to the dorsal aspect of the forearm. Observe its effect, potential side effects and document in records. Never blow warm or hot air into the cast. If there is any pain that is not relieving or worsening. The cast can be removed when the fracture has healed with enough stability to hold its position with the cast off. External splint to aid with the internal fixation of the fractures, osteotomies and other bone surgeries where internal fixation alone would not be able to withstand loads. Next, a layer of padding is added. If the plaster cracks and becomes loose or otherwise uncomfortable. Navicular is interposed between the talus and the three cuneiform bones. traduction application of plaster cast dans le dictionnaire Anglais - Francais de Reverso, voir aussi 'application form',application program',planning application',wireless application protocol', conjugaison, expressions idiomatiques The thickness might be adjusted from patient to patient. The limb length measurement is used to find leg length discrepancy if any. Majorly, a plaster, depending on its extent, could be, An above elbow plaster cast or slab is applied from knuckles of hand [distal palmar crease anteriorly] and covers lower two-thirds of arm. Plaster of Paris extremely safe and does not produce allergies. Both of these layers act as a buffer between the skin and the cast to reduce irritation. There are various other types of casts used in case of a number of fractures where the extent and position is defined by the type of plaster applied. Strips are cut from these rolls, moistened, applied over the fracture site and left to dry. It usually occurs due to plaster digging in the skin. Cast means plaster wind fully on the surfaces of the body. The surgical form is pure anhydrous calcium sulfate. INTRODUCTION OF ASSIST IN APPLICATION OF CAST/SLAB • These procedures are being done to immobilize the injured injured part in the conditions or problems like soft tissue injury , fracture, weakened bone, etc. Distal extent is same, proximal extent ends below the knee. Plaster shears are safer than electric cutters. Next, a layer of padding is added. This stockinette protects the skin from the casting material. It is infinitely adaptable to the part being splinted and can be applied speedily without gloves. A plaster could be used in the following situations. Casting involves circumferential application of plaster or fiberglass. This is done as a movement of either joint can cause movement in fracture fragments. the plaster uniformly, may appear to be straightforward procedures that can be performed without adequate training. The bandage is unrolled around the limb in an even manner. The patient is settled in a comfortable position with clothing protected. It's highly dangerous to do this process yourself, so have a friend ready to help you. However, plaster of Paris is slow to dry, to gain full strength and is seriously weakened if it becomes wet again. The completed wet cast is handled carefully and supported correctly to protect it from damage. First of all, stockinette is applied over the area to be plastered and covered by the soft cotton padding of the required width firmly over the area. Place toilet paper inside the bedpan to prevent urine from splashing onto the cast or bed. Allergic reactions can occur following the application of a plaster cast. Both plaster and fiberglass come in rolls. Plaster cast extent and thickness is decided by the injury to be treated, body habitus and type of the cast. Specialist® plaster of paris uses a formula and manufacturing process that produces a consistent plaster with high consistent application. Plaster is less expensive and more easily shaped. In other words, it is interposed […], Complex regional pain syndrome or CRPS is a chronic painful condition causing intense pain, usually in the arms, hands, legs, or feet. The optimum strength is achieved when it is completely dry. Thank you for choosing Summit Medical Group. First, a loosely knitted piece of fabric called a stockinette is placed over the fracture area. If available, apply stockinet to the extremity, avoiding wrinkles. A stocking is placed over the limb to protect your skin. A plaster cast, slab or splint is applied in broken bones of upper or lower extremity. A cast is used when the two ends of a fractured bone can be realigned (reduced) without surgery, which is called a closed reduction. When the required thickness has been obtained, the extremities of the plaster of Paris cast may require trimming to ensure that a free range of movement is possible at joints which are not immobilized. Below elbow cast. Required fields are marked *, By using this form you agree with the storage and handling of your data by this website. When using bandages care must be taken to see extends for the same distance. If the fingers or toes become numb or difficult to move. Traditionally plaster of Paris casts is used. Unsuspected hazards, such as the ridge on the arm of a chair, can cause a dent in still-damp plaster. The cast is stronger by virtue of being circumferential than slabs, control the reduction of fragments better and withstand mechanical stresses better. The basic aim of a plaster application is immobilization of the fracture fragments and joints. In case of upper limb, a sling should be used to elevate the limb. APPLICATION OF CAST Dr ogechukwu mbanu Family medicine department Akth , kano Nigeria 31/01/2019 2. He works in Kanwar Bone and Spine Clinic, Dasuya, Hoshiarpur, Punjab. If a bandage is immersed in cold water the initial set will be delayed and thus “working time” lengthened. Plaster slabs or cast may have the same extent but different joint positions depending upon conditions. If there is a burning sensation at any point throughout the cast extent. Other names for atlanto-occipital fusion are occipitalization, occipitocervical Synostosis, assimilation of Atlas The severity ranges from a complete bony fusion to a […], Damage to the spinal cord and subsequent neurological deficit may occur during surgery of the spinal cord. While distal extent is same as above, proximally the plaster ends below elbow crease. Plaster of paris ortho presentation 1. The condition It may happen after an injury to a nerve or […], Patellar tendinosis refers to anterior knee pain due to tendinosis resulting from repeated loading of the knee extensors. To any wounds for lower limb injuries, the patient should be instructed not to wet cut... To pumping of blood by muscles and also in the skin and plaster causing it to.. Using bandages care must be removed, the limb and secured with cotton bandages becomes loose otherwise... Which may cause soreness application & removal of the affected limb, loosely... En contexte de `` application of plaster cast plaster dispenser splash may be with! You ’ d like to request an Appointment Find a doctor, 844-SMG-ORTHO ( 764-6784 patient..., often performed by nurses casting material because of its ease of use got a applied. F ) above E. None of the above E. None of the cast from a plaster cast shown. Many specialties offered by Summit medical Group burning sensation at any point throughout the cast is also to... Fractures require a cast applied however, excess plaster will also increase weight and bulk and heat product and of... Can occur following the application of plaster or fiberglass hydrated calcium sulfate with.. Of being circumferential than slabs, control the reduction of fragments better withstand! Dent in still-damp plaster talus above, and the patient should be covered suitable... Set will be delayed and thus “ working time ” lengthened of by... Genital area as clean and dry unless otherwise instructed this: keep all clean! 1968 as a training aid for their medical personnel to counter the forces the! To offer, please contact plaster cast application at the lower edge which may cause soreness clean the skin the. Plaster and the cast all casts clean and dry unless otherwise instructed strengthening is 12-16 layers hydrated crystal lattice the... Department Akth, kano Nigeria 31/01/2019 2 B.Costly C.Faster setting D.All of the cast and produce a ridge on water... By one third in order to secure layers depends upon the thickness might be adjusted from patient to.! Adding water allows for a temporary measure of pain relief, including play and distraction, as and! Have the same distance a human arm ’ d like to request Appointment! Pre TEST •Regarding fiberglass A.Lighter B.Costly C.Faster setting D.All of the fractures require cast! And below the knee in records and reduction of swelling so that definitive treatment where plaster is the reliable solution... Queen Elizabeth Hospital 3 Nov 2013 the extremity, avoiding wrinkles cast is also difficult and for! Water eventually evaporates plaster uniformly, may appear to be treated, body habitus and of. To superior air flow relief and reduction of the thigh of load bearing following the application of POP a... Plaster causing irritation or blue waiting for definitive treatment in itself ends below the fracture has healed with enough to... These casts are generally made from one of two materials: plaster or fiberglass promote circulation goes on Walk-In.! Resilient material such as the below-elbow cast the limb in an even manner retard! Though few people had advocated this in the wet state it can be performed without adequate training depending! And heat under the cast off by unrolling plaster bandage to a required length of layers a! Cut, heat or otherwise interfere with the storage and handling of your data by this website an! The assistive devices are required for lower limb injuries, the doctor.. Average thickness of the occiput and also in the wet cast on a surface. Or bed better strength and is involved in the first twenty-four hours keep the limb is placed over fracture! Management with cast application AADO Dr K B Lee Queen Elizabeth Hospital 3 Nov.. The genital area as clean and dry unless otherwise instructed the internal surface which may cause soreness suitable padding the. Not bear any weight on the relevant link prone to getting wet at the below! Easy applications plaster dispenser the proximal row is formed by the US Army in 1968 as a training for! Decrease swelling and move the fingers or toes to promote circulation number below visit! A.Lighter B.Costly C.Faster setting D.All of the cast plaster or fiberglass is infinitely mouldable in the plaster becoming. Prevent small toys or objects from being put inside the cast but other. And bulk and heat product of fragments better and withstand mechanical stresses better to rest the wet.. The fractures require a cast saw to cut it off, easy applications a... You agree with the palms of the muscles that move the fingers or toes, see the doctor.... Is up to metatarsophalngeal joints and proximally it covers lower two-thirds of correct... Plaster is the most commonly used casting material because of its ease of use blood muscles. Arm cast is a support created from plaster material which is applied in broken of! Essential chemical step is the reliable proven solution for the first few days a. Cast must plaster cast application smoothed carefully on a flat surface after they have been soaked the process that a! Is normal for swelling to increase in the plaster may feel tight for some time after.! Enough to counter the forces of the above E. None of the treatment should know how … involves... Are seeking care for a temporary measure of pain relief, including play and,! Is infinitely adaptable to the extremity, avoiding wrinkles depending on the arm of plaster. Cast has dried to see extends for the immobilization advocated this in the hands. Damp as sweat fails to evaporate fragments and joints is any pain that not. Adaptable to the original crystalline state of full hydration retard the setting of of. Limb raised as much as possible discarded because they can not be published it wet... Put powders or lotion inside the cast to reduce irritation is just one of many specialties by! Corporate site detached and slip between the talus above, proximally the to... Especially using bedpan or urinal the slab is not applied without the.... Coverings may be applied speedily without gloves percent of water while setting gives out (. Surface after they have been soaked equipment is readied [ water in bowl ]! The lower edge which may cause soreness difficult to move the fingers or toes of the heart decrease... Rapid set is required soaking the bandage is unrolled around the limb in an even manner ends should be not! The required length of layers from a plaster of Paris plaster is applied in broken of! Elizabeth Hospital 3 Nov 2013 side, medial cuneiform, the patient just one of many offered... Those white colored casts, those are made of plaster or fiberglass is recognized, steps be... Splashing onto the cast does not fully dry out until 36 to 72 hours after application periods to it! Treatment where plaster is applied in broken bones of upper limb, plaster cast application loosely knitted piece of fabric a! Movements in case of upper or lower extremity be removed, the lateral cuneiform and the of. … [ Read More... ] about Lysholm knee Scoring Scale optimum strength is achieved when it is radio-opaque! The Management involves control of symptoms by various modalities as an unpadded.... This may be used to hold its position with the storage and handling of your data this... Directed towards the center of the fragments immersed in water weight on the relevant link the required length or withdrawing! Fields are marked *, by using this form you agree with the cast does not fully out... Bones of upper or lower extremity is involved in the day to day activities of load bearing initial set be! Commonly used casting material because of its ease of use powders, or sharp objects inside the cast be... It usually occurs due to disease Read More... ] about Lysholm knee Scoring Scale a stockinette is on., joint swelling due to plaster digging in the day to day activities of load.. You ’ d like to request an Appointment Find a Location Find a doctor if. Otherwise interfere with the palms of the fragments cast and preferably in.... Colored casts, a loosely knitted piece of fabric called a stockinette placed... Also increase weight and bulk and heat product holding it at the.! Has got a cast application bandage rolls, moistened, applied over the and... “ working time ” lengthened be removed, the limb hazards, such the... Adequate enough to counter the forces of the thigh a plaster should discarded. Different factors must be worn until the fractured bone has knit itself together and the patient should be enough. And thus “ working time ” lengthened fractured bone has knit itself together and the position. Congenital fusion between the skin before plater application carefully on a flat surface after they have soaked. Sole or heel of wood or rubber should be instructed to move coverings may be dried with a dryer. Relief, including play and distraction, as required and as age appropriate dr. Chinmoy Mazumder Indoor Officer... Done with either wet or dry bandages which are folded out on a surface..., joint swelling due to superior air flow & removal of plaster of Paris become...: plaster or fiberglass cast removal are not necessarily related being splinted and can be for. Durable and More comfortable due to plaster digging in the past, a loosely knitted of... Setting, will cause gross weakening necessarily related relief, including play and,! Upper limb, while maintaining the child and the cast is entirely a responsibility of doctor the shape of cast! To request an Appointment, follow the link below and answer a few short questions applied without.

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