CastManualSample-CastingWorkshop.PDFVIP

INTRODUCTION Immobilization of injured bones, joints, ligaments, or muscles has been practiced traditionally, if nothing else, because of the comfort that immobilization provides. The types of methods and means of immobilization of fractures have expanded over the years. Early methods were limited to splints and traction. These methods were used worldwide for many generations, to be gradually replaced by plaster casts. Today many materials are available to fabricate casts, splints and braces (orthoses) including thermoplastic and fiber reinforced materials. As a means of fracture immobilization, internal fixation became possible less than a century ago when anesthesia was invented and avoidance of infection became a reality. Internal plates and intramedullary nails, as well as external fixators, have gained enormous popularity. These advances have had positive effects in the management of the majority of fractures. Metallurgical improvements and new imaging techniques that facilitate surgery, particularly in the case of intra-medullary fixation of long bones, have solidify the definite place of surgery in the care of fractures. Despite all the improvements in the surgical management of the skeletally injured patient, casting and bracing have a permanent place in the armamentarium of the orthopaedic surgeon. There is not as yet a single method of treatment, surgical or non-surgical, that applies to all fractures and under all circumstances. In this Manual we attempt to summarize the most current techniques of casting and bracing of some of the most common fractures. Though it is generally perceived that casts, splints and braces “immobilize” fractures, the reality is that they do not. They simply “stabilize” them to different degrees. This “lack” of immobilization, rather than being a problem is a benefit, because rigid immobilization of fractures is unphysiological; it