The closed management of fractures and the application of plasters remains a core component of orthopaedic trauma management. A prospective audit was undertaken to analyse the quality of plasters presenting from various sources to the Fracture Clinic Plaster Technicians.

A prospective audit was conducted of 120 consecutive cases that presented to the Plaster Technicians at Western Health which had plasters applied by other institutions or other departments. The plasters were assessed on a number of criteria for adequacy and appropriateness using a standardised questionnaire and set guidelines.

63% of plasters applied were found to be deficient, inadequate or needed improvement. Of those applied by Theatre doctors, only 20% were appropriate. Of plasters applied by Emergency doctors only 10% were appropriate and those applied by General Practitioners were consistently deficient. Only trained plaster technicians had an acceptable rate of >90%. A large portion of the errors were due to incorrect moulding, joint position and fracture alignment.

Improperly applied plasters lead to increased morbidity, require reapplication or unnecessary operative procedures due to loss of position. Ongoing education and review is critical to address this situation, and a national online database is being designed and implemented to monitor this situation nationally.