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Setting temperatures of plaster casts. The influence of technical variables.

It is known that plaster-of-Paris casts can cause burns. Experiments were done to determine what factors are involved in causing an elevation of the temperature in a freshly applied cast. A glass tube filled with water between the temperatures of 36 and 39 degrees Celsius was used to simulate a leg for this study. Standard plaster casts were applied to the tube and the following variables were studied: different temperatures of the dip water; different thicknesses of the cast; the presence of plaster residue in the dip water; and the effect of the plaster of a pillow placed under the tube. It was found that if the temperature of the dip water was higher than 24 degrees Celsius or the thickness of the cast was greater than eight ply, or both, and if the pillow was used to limit the dissipation of heat from the cast, temperatures high enough to cause skin burns could occasionally be reached. Variable results indicated that these were the factors operating in practice and that a combination of them posed the greatest hazard.

Burns↗

[You and your plaster cast--educating for health].

The study was developed in order to give patients carrying a plaster cast orientation into self-care. The authors supported their work on pre-existing works on the same theme. They point to Education for health as a means for health professionals to prevent problems arising from misinformation to people under medical attendance.

Casts, Surgical↗

Experimental investigations on the hypokinesis of skeletal muscles with different functions, VIII. Effect of plaster-cast immobilization on the contractile properties of rat skeletal muscles with different functions.

The plaster-cast immobilization of the right hind limbs of rats has been investigated. Examinations were performed on the changes in weight of both types of skeletal muscles, i.e. the fast and the slow ones, the m. extensor digitorum longus and the m. gastrocnemius on the one hand, and the m. soleus on the other. The most significant loss in weight was observed in the gastrocnemius muscle. The ATP-Ca2+-induced isometric tension as well as the speed of contraction of glycerine-treated myofibrillar preparations considerably decreased as a result of 28-day immobilization. The most marked change was observed in the soleus muscle. There was a similar decrease in the specific activity of myofibrillar myosin ATPase prepared from immobilized muscles. The specific activity of K+-EDTA myosin ATPase did not change.

Adenosine Triphosphatases↗

Energy costs of walking in lower-extremity plaster casts.

The energy cost of walking with axillary crutches and each of three types of plaster casts (long, short, and cylinder) on the lower extremity was measured in twenty normal adult men. The knee and ankle joints were immobilized unilaterally in the neutral positions. Oxygen uptake was measured using a modified Douglas-bag technique. Heart rate, respiratory rate, and step frequency were telemetered from transducers that were attached to the subjects. When walking and bearing full weight on a cast without the use of crutches, the average rates of energy expenditure for subjects wearing the three varieties of casts did not significantly differ from the value for normal walking. Velocity, however, was reduced depending on the extent of immobilization. The average velocity of the subjects was fifty-six meters per minute in a long cast, sixty-four meters per minute in in a cylinder cast, and seventy meters per minute in a short cast, compared with seventy-eight meters per minute without immobilization of the limb. The subjects' average oxygen cost per meter was 0.24 milliliter per kilogram in a long cast, 0.20 milliliter per kilogram in a cylinder cast, and 0.19 milliliter per kilogram in a short cast, compared with 0.15 milliliter per kilogram for normal walking. Using a unilateral non-weight-bearing swing-through gait, the average rate of oxygen uptake for subjects wearing the three types of casts did not differ from the mean value without a cast (21.2 milliliters per kilogram per minute). All values were at least 60 per cent higher than the average for normal level walking.

Adult↗

The effect of remobilisation on the extremity of the adult rat after short-term immobilisation in a plaster cast.

The one hind leg of adult male rats was immobilised for 4 weeks in a plaster cast. The cast was then removed and the leg was subsequently remobilised for 4 and 16 weeks respectively. Studies of the skeletal mass of the femur and the tibia from the immobilised leg showed that after 4 weeks of remobilisation there were still clear signs of osteoporotic changes of the bones as compared with the corresponding bones from control non-immobilised rats. After 16 weeks of remobilisation there were no esteoporotic changes detectable by the methods used.

Animals↗

Effect of plaster-cast immobilization on the contractile properties of rabbit skeletal muscles of various functions.

The effect of plaster-cast immobilization was studied on the ATP-Ca++-induced contraction of glycerinated muscle fibres on myofibrillar superprecipitation and on the ATPase activity of gastrocnemius and soleus muscles obtained from rabbit hind limb. Following 28 days of immobilization the ATP-Ca++-induced tension of glycerinated muscle fibres prepared from the gastrocnemius and soleus muscles decreased significantly. Decreases in superprecipitation and in myofibrillar ATPase activity were less significant. It seems reasonable to conclude that the changes in the physiological parameters of isolated muscle fibres have been due to the alterations in the myofibrillar proteins induced by reduced activity of the muscles.

Adenosine Triphosphatases↗

[Treatment without plaster cast of intra-articular fractures of calcaneus united by means of a kirschner wire bundle].

A treatment without plaster cast is presented of intra-articular fractures of calcaneus. In nine patients after fracture reduction by the Westhues method or by operation, the fragments were united by means of divergent bundle of Kirschner wires, introduced from the side of calcaneal tuber. The obtained stabilization made possible an early rehabilitation treatment. In no case a secondary displacement of fragments occurred after removal of uniting wires. Poor result was noted only after surgical treatment complicated with osteitis.

Adult↗

Minimally displaced Colles' fractures: a prospective randomized trial of treatment with a wrist splint or a plaster cast.

Sixty-six adult patients with minimally displaced distal radial fractures were randomly assigned to treatment with either a plaster cast or a lightweight removable wrist splint. Outcome assessment was by clinical and radiological evaluation and an independent physiotherapy assessment. There were significant differences between the treatments for cast satisfaction, cast problems and the functional assessment score at 6 weeks, with the removable splint scoring better in all cases.

Activities of Daily Living↗

The treatment of tibial fractures by elastic nailing and functional plaster cast.

From June 1984 to December 1985, 32 fractures of the tibia were treated by elastic nailing by the Ender method with functional plaster casts according to the Sarmiento method. They represented 28% of all tibial fractures treated during the same period by the traditional conservative method or by external fixators. Elastic nailing was reserved for unstable fractures produced by high velocity trauma. Union occurred in all cases after an average of 13 weeks. Complications were insignificant: shortening by 1.2 cm (1 case); recurvatum (1 case); varus (1 case); valgus (1 case), both less than 8 degrees, and thus within functionally insignificant limits for axial deviation. In one case, a 15 degree internal rotation deformity was corrected after 5 weeks by osteoclasis and fresh elastic nailing which also healed. The advantages of this type of treatment are rapid union and no pseudarthrosis or infection.

Adolescent↗

Quantification of fMRI artifact reduction by a novel plaster cast head holder.

In light of artifact-induced high variability of activation in fMRI repeat studies, we developed and tested a clinically useful plaster cast head holder (PCH) with improved immobilization, repositioning, and comfort. With PCH, there were considerably lower levels of translational and rotational head motion components compared to head fixation with conventional restraining straps (CRS). Rotational components cannot be fully compensated by realignment and lead to "false activations." In addition, task-correlated head motion, which highly increases the risk of artifacts, was considerably reduced with PCH, especially in a motion prone subject. Compared with PCH, head motion was 133% larger with CRS in a highly cooperative subject. With a motion prone subject, head motion range was increased by 769% (PCH: 0.9 mm, CRS: 7.8 mm), which may indicate the usefulness of PCH for restless patients. In functional activation maps, PCH alone yielded fewer residual motion artifacts than CRS + image registration. Subject tolerance of the head holder during the long measurement times of up to 2.5 hr was good, and slice orientation on different days confirmed the quality of repositioning.

Adult↗

Fiberglass versus plaster casts. How to choose between them.

Both fiberglass and plaster of Paris casts have advantages and disadvantages, and the choice of material depends on the individual situation. Fiberglass is used most often, but plaster of Paris, with its molding capabilities, is the first choice for fresh extremity fractures. "Hybrid" casts offer no advantages.

Calcium Sulfate↗

Patellar tendon bearing plaster casts in fractures of the tibia.

One hundred fractures of the tibial shaft were treated by early weight-bearing in a below knee patellar tendon bearing plaster cast. The rate of union, and the range of knee and ankle motion were assessed. Ninety-five per cent had good or excellent results. This method of treatment is particularly valuable in the third world because it avoids the complications of operation and also of traditional conservative methods.

Adolescent↗

[Vascular compression of the duodenum related to a plaster cast (the cast syndrome)].

Case report of a 15-year-old girl presenting compression of the duodenum by the superior mesenteric artery, occurring after the application of a body plaster cast for correction of a idiopathic thoracic scoliosis, which required a gastrojejunostomy. The clinical and radiological pictures of this case fall into the rare entity called the "cast syndrome". The salient features of this syndrome are commented.

Adolescent↗

Quantification of intracompartmental pressure and volume under plaster casts.

UNLABELLED: Infusion lines (to elevate intracompartmental pressure experimentally) and wick catheters (to monitor the pressure produced) were inserted into hind-limb muscle compartments in twenty-six dogs. A padded plaster cast was then applied. The effect of the cast on intracompartmental pressure and volume and the effect of first splitting the cast and then cutting the padding were determined. Three different padding were used: dry Webril, Webril soaked in blood and Betadine (povidone-iodine), and Webril soaked in blood and Betadine and then dried. The cast was found to restrict expansion of the compartment volume by approximately 40 per cent. The most significant reductions in pressure in all groups occurred after the cast was cut and spread (mean reduction, 65 per cent). An additional pressure reduction of 10 to 20 per cent occurred after cutting the Webril. After removal of the cast, all limbs maintained some residual elevation of the intracompartmental pressure. CLINICAL RELEVANCE: This study demonstrates the need in clinical practice for continued evaluation and monitoring of a limb even after the cast has been completely removed because of signs and symptoms of a compartmental syndrome.

Animals↗

Clinical fracture of the carpal scaphoid--supportive bandage or plaster cast immobilization?

In a prospective study of 108 patients with a clinical diagnosis of fracture of the carpal scaphoid, but without radiological evidence of fracture, the patients were randomised to treatment with either a supportive bandage or a dorsal plaster cast. Four patients proved to have incomplete fractures and three to have avulsions from the scaphoid tuberosity. Two of the fractures had been suspected radiologically at the primary investigation. No complete fractures of the scaphoid were seen. The average time in plaster was 15 days and in a bandage 12.2 days. The average sick leave for manual workers was 14 days in plaster and 4 days in a bandage, a difference that represents a significant loss of productivity. Since these fractures almost always heal irrespective of treatment, they may as well be treated as a soft tissue injury with a supportive bandage.

Adolescent↗

The use of plaster casts in the treatment of fractures of the femoral shaft.

In order to relieve the pressure on an overworked fracture service, the early mobilization of patients with fractures of the femoral shaft in plaster casts was investigated. The cast is designed to have a weight-relieving function and to mould the soft tissues of the thigh around the fracture. Using this method, 40 patients were discharged from hospital in an average of 44 days from injury and all their fractures healed rapidly and successfully.

Adolescent↗

[Plaster casts].

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Casts, Surgical↗