Robert Jones Bandage in Cats
Dr. Nicholas Trout
The Robert Jones bandage is probably the most common form of external splint applied to a limb for the temporary support of a fracture.
Following trauma, fractures, shearing injuries and joint luxations are common but do not cause immediate life threatening problems to the patient. After being hit by a car, for example, a veterinarian will be more concerned with vital body systems. In an emergency situation the injuries sustained by your dog must be prioritized and, despite the unpleasant appearance of a broken leg, this problem will not be high on the list of concerns relative to breathing difficulties and bleeding problems.
For these reasons a temporary bandage is applied to an injured limb. This bandage is appropriate for trauma below the stifle (knee) or below the elbow. The axilla (armpit) and the groin limit how high this type of bandage can be placed, and so fractures of the humerus and femur would receive poor support and protection. In fact, with a bandage in place, femoral and humeral fractures may be worse off as the fracture site becomes a pivot point due to the weight of the bandage material below.
The Robert Jones bandage is large and cumbersome, but it aims to provide support, immobilization of the fracture or dislocation, and comfort.
Tape stirrups are applied to the toes initially. If a wound is present it may be clipped, cleaned, and dressed, but again, the importance of the injury will be considered in light of your pet's other problems.
Rolled cotton makes up the bulk of the bandage and may be quite thick, possibly four to six inches, which can appear to be disproportionate to the size of the leg. Elastic gauze is then wrapped over the cotton to compress it and produce smooth even tension over the length of the bandage. The outer layer is formed by elastic tape such as Elasticon® or Vetrap®.
The elastic gauze is wrapped with sufficient tightness that the bandage will sound like a ripe watermelon when tapped.
The toes will appear at the bottom of the bandage and these should be assessed twice daily for swelling, sweating or pain. It is very important to keep this bandage clean and dry during the time that it is in place. For this reason the patient should remain indoors and confined. If a cat is able to go outside to go to the bathroom then a plastic bag or trash can liner must be placed over the foot and the length of the bandage. This should be done even if the ground appears to be dry as many pets can inadvertently urinate on their large bulky bandage, necessitating a bandage change.
If the bandage remains clean and dry, and the toes do not swell or have any problems, then the bandage can remain in place for several days until the animal is sufficiently stable to have the orthopedic problem addressed.
Sometimes a cat may be bothered by the presence of a bandage. This could be due to problems at the site of the underlying injury. Elizabethan collars can be helpful if they just resent the limb or the toes being confined, but excessive chewing or licking should not be overlooked and veterinary advice should be sought if you are worried.
The top of the bandage, particularly in straight-legged cats may have a tendency to "telescope" down the leg. This can cause the material to bunch up and abrade the limb. If this occurs, or chaffing or rubbing occurs for other reasons, the bandage should be changed.