PubMed · 12645479
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2003-02-07. Casting and strapping rules.. https://pubmed.ncbi.nlm.nih.gov/12645479/
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Split plaster casts have been shown to be better than back slabs at accommodating increasing intracompartmental pressure due to swelling. Splitting a wet plaster cast can be time consuming and difficult both for the patient and the medical staff. We describe a novel method of applying a split plaster of Paris cast, which is safe, quick, convenient and inexpensive.
Plaster of Paris has been largely superceded for casting in orthopedic departments by synthetic cast materials. Despite its weight, its relative brittleness, its unpopularity with patients, and its messiness in application, plaster of Paris remains the mainstay of casting in the emergency department. This is due to a combination of economic reasons, the belief that synthetic casts leave less room for swelling and its relative ease of application compared to synthetic materials. We present a technique for synthetic cast application that avoids the problems of the rapidly setting cast and therefore allows the time for less experienced hands to produce a well-fitting cast or splint. We believe that this option, which allows the patient to have a lighter synthetic cast, rather than the traditional plaster of Paris cast, will be welcomed by both the patient and physician.
Flexor tendon repair in zone II is still a technically demanding procedure, but the outcomes have become more predictable and satisfying. Of keystone importance for obtaining the goals of normal strength and gliding of repaired flexor tendons are an atraumatic surgical technique, an appropriate suture material, a competent pulley system, and the use of early motion rehabilitation protocols. The overall goal of hand and finger function also implies timely addressing of neurovascular injuries. New devices such as the TenoFix (Ortheon Medical; Winter Park, Florida) have shown adequate strength in the laboratory but are bulky and untested for work of flexion. Insufficient clinical data and high cost may prevent widespread use.