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Casting is a procedure that orthopedic surgeons use in encasing a limb, or in some cases large portion of the body, to stabilize and hold anatomical structures, most often a broken bone or bones, in place until healing is confirmed. It is preferably used because it is a safe mode of treatment and the materials in plaster hardens quickly after it has been made wet. Casting is still in use for management of fracture in most hospitals and clinic all over the world.
However, after my personal experience, and assessing many patients that used the orthopedic cast procedure, I observed and researched upon some adverse effects/complications of using casting.
Water mixed with plaster to form a cast is molded around a broken limb. After modeling the cast, it becomes hardened, and the patient carries it for as long as the doctor recommends. During this time, the limb is unreachable and patient has some difficulty when taking a shower because the cast must remain dry. The skin under becomes dry and scaly because the discarded outer skin are not washed off. Also, the pressure of the plaster on the skin may result in cutaneous complications including maceration, rashes, burning, itching which can injure the skin and lead to open sore (ulceration). Heat may cause a staphylococcal infection of the hair follicles and sweat glands leading to allergic contact dermatitis.
Another complication is that cast is heavy, and may restrict movement, especially of a child. It may cause stiff joints, muscle wasting, and impaired circulation.
We are in the modern age and we as physical therapists should embrace and update inventions by supporting evolution of materials used in rehabilitation of broken bones to minimize these side effects.
Below, is the cortex cast made of strong plastic, wires, fibers etc. and designed to fit some types of fractures like; Linear, Traverse, Oblique non-displaced, Oblique displaced, and Greenstick. The Cortex exoskeletal cast provides a highly technical and trauma zone localized support system that is fully ventilated, super light, shower friendly, hygienic, recyclable, and stylish. It utilizes the x-ray of a patient with a fracture and generates a 3D model in relation to the point of fracture.
A patient would have the bones x-rayed and the outside of the limb 3D-scanned. Computer software would then determine the optimum bespoke shape, with denser support focused around the fracture itself.
The polyamide pieces would be printed on-site and clip into place with fastenings that can’t be undone until the healing process is complete, when they would be taken off with tools at the hospital as normal. Unlike current casts, the materials could then be recycled.
I would like to spread this awareness to my Physical Therapy colleagues to improve our jobs and services in hospitals, clinics and the overall healthcare system around the world.
For more information on the cortex cast concept, check out Jack Evill website