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PubMed · 12584974

[Orthopedic immobilization].

Abstract

The classical plaster bandage was devised in the mid 19th century. Until recently, osteoarticular trauma has been treated mostly by plaster cast immobilisation using plaster of Paris. Synthetic materials have been introduced on the market place in the seventies, but they have not superseded the traditional plaster of Paris. The more recent thermoplastic materials are used to make splints and orthoses, particularly at the wrist and hand. The present review of the literature confirms that synthetic materials present better physical and mechanical properties than the traditional plaster of Paris. In addition, they are lighter, they are more resistant to humidity, they are more radiotransparent and they generate less dust when removed. However, they are less malleable and cause higher pressure in case of limb edema. Plaster of Paris therefore remains indicated in the acute posttraumatic or postoperative period. This material is also cheaper, but the pecuniary benefit is limited for several reasons, particularly because plaster of Paris is associated with a higher rate of cast replacement.

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BibTeXRIS

F Schuind, F Moulart, J M Liegeois, L Dejaie, C Strens, F Burny. 2002. [Orthopedic immobilization].. https://pubmed.ncbi.nlm.nih.gov/12584974/

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Gap index: a good predictor of failure of plaster cast in distal third radius fractures.

The aim of this study was to assess the usefulness of the cast index and an indigenously developed gap index as measures of poor moulding of plaster. Twenty cases of re-manipulation of distal third radius fractures in children excluding growth plate injuries were compared with a control of 80 patients. A significant difference (<0.001) was observed in the cast index and the gap index of both the groups. The gap index was more sensitive than the cast index in predicting failure. At a level of cast index of more than 0.8 the relative risk of failure is 6.8 as compared with 35 when the sum of the gap index is more than 0.15. The gap index is a better predictor of failure than the cast index. A quick assessment of these indices is a good practice before accepting any plaster following a manipulation of distal radial fractures.

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