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At least 595 records · Page 33Linked to original sources
PubMed1989

The stiffness of cylindrical casts enforced with splint laminations: biomechanical considerations.

Splint lamination is often used to strengthen a plaster cast while minimizing its thickness and weight. We evaluated the following lamination configurations to determine the effectiveness of each relative to a 3-mm-thick short leg cast: anterior-posterior splints, medial-lateral splints, and an anteriorly placed fin. Theoretical stiffness was calculated as a function of the area moment of inertia, and then the actual casts were tested in three-point bending on a servohydraulic apparatus. The experimental results were correlated with the calculated data, and finite element studies were performed to correlate the experimental results with the geometries of the casts. The theoretical and experimental data indicate that anterior-posterior splint lamination reinforcement stiffens a cylindrical cast to flexion-extension bending moments more effectively than does medial-lateral splint placement. An anterior fin can stiffen the cast as effectively as a splint can. However, the fin must be relatively large, which may cause it to accentuate problems with clothing and be difficult to apply.

Biomechanical Phenomena↗
PubMed2006

Is it possible to decrease skin temperature with ice packs under casts and bandages? A cross-sectional, randomized trial on normal and swollen ankles.

INTRODUCTION: There is a general belief that the presence of a cast or a bandage eliminates the lowering effects of skin temperature when local cold therapy applied on the surface of the cast or bandage. The purpose of this study is to determine the magnitude of temperature changes at the skin of the ankle after the application of frozen ice packs to the surface of various casts and bandages both in normal and swollen ankles. MATERIALS AND METHODS: Thirty-two healthy subjects (Group A) and 12 patients with Grade III inversion type acute ankle sprain (Group B) were randomly divided into four groups. The sensor of the digital thermometer was secured to the ankle over the anterior talo-fibular ligament in every subject before placement of a bandage or cast. Robert Jones bandage, elastic support bandage, a below-knee plaster cast and synthetic below-knee cast were applied in groups 1, 2, 3 and 4, respectively. Two frozen ice packs were placed around the cast or bandage at the level of sensor, and skin temperatures were recorded. RESULTS: The skin temperature under dressings and casts decreased significantly relative to the baseline temperatures with local cold therapy in all groups. The fall in the temperature with cryotherapy in group A showed a three-phase pattern of change between groups 1 and 2, groups 2 and 3 and groups 2 and 4 during the experiment. The fall in the skin temperature with ice packs differed significantly between groups 1 and 3, and also groups 1 and 4 from the beginning till the end of the experiment. There was no significant difference between groups 3 and 4 in terms of skin temperature fall with cryotherapy during the whole experiment. The results were similar in group B. CONCLUSION: A bandage or cast does not prevent measurable skin temperature lowering by frozen ice packs both in normal and swollen ankles.

Adult↗
PubMed2006

Precision of landmark positioning on digitized models from patients with cleft lip and palate.

OBJECTIVE: To quantify the precision of landmark positioning on digitized casts of patients with unilateral cleft lip and palate. PATIENTS: Forty plaster models of newborns up to 8 months of age were selected from the archive of the Department of Orthodontics of the University of Heidelberg. MATERIAL AND METHOD: The plaster-cast models were digitized with a Micromeasure 70 three-dimensional laser scanner (Micromeasure, Bischoffen, Germany). The laser scanner used in this study operates with a precision of 0.15 mm on the x- and y-axes and 0.06 mm on the z-axis. In the intraobserver study, a single observer placed anatomical landmarks in four rounds, with at least 4 weeks between each round. In the interobserver study, four different observers each placed the same landmarks once. For the two different studies, an ideal location for each landmark was calculated by averaging the landmark positions of the four rounds or observers. The distance between each of the four landmark positions and the ideal landmark was measured. RESULTS: A 95% confidence interval for the landmark positioning error was calculated. For the intraobserver investigation, this error was 0.34 to 1.30 mm, and for the interobserver investigation it was 0.7 to 2.00 mm. CONCLUSION: Because both investigations displayed comparable error intervals, it was concluded that different observers could perform landmark positioning for the same studies.

Cleft Lip↗
PubMed1993

Biometric analysis of the dental casts of Maasai following traditional extraction of mandibular permanent central incisors and of Kikuyu children.

Dental plaster casts of 93 Maasai and 79 Kikuyu children age 12-15 years were analysed. Four biometric measurements were taken of the maxillary and mandibular casts: intercanine distance (C-C), inter-molar distance (M-M), canine arch circumference (C-C ACirc.), and molar arch circumference (M-M ACirc.). Incisor space (IS) was also measured in the mandibular casts. The mean values of all measurements except (M-M) in the mandibular casts were significantly reduced in the Maasai who had permanent central incisors extracted compared to the non-extracted Maasai and the Kikuyu. The mean incisor space in the Maasai with extractions was 6.3 mm compared to 11.7 mm in the non-extracted Maasai group. The extent of reduction of IS, C-C, C-C ACirc. and M-M ACirc. following extractions of the incisors may depend on the mesial drift of lateral incisors, jaw growth and soft tissue influence. The position of the tongue and occlusal relationship of the molars may prevent bucco-lingual movements maintaining a constant M-M. There was no significant difference in the mandibular cast dimensions of the non-extracted Maasai and the Kikuyu. Analysis of the maxillary cast dimensions of the Maasai with extraction, non-extracted Maasai and Kikuyu showed no significant differences suggesting that the extraction of mandibular incisors has no effect on maxillary arch dimensions. The variability in growth of the dento-alveolar complex itself may explain why the dental arch dimensions are similar in the Maasai and Kikuyu despite ethnic differences. There was no significant difference between the male and female dental arch dimensions.

Adolescent↗
PubMed1990

[Secondary dislocations in fractures of the distal end of the radius].

In the group of 31 patients treated by immobilization of the forearm we observed 71% of secondary dislocations and in group of 46 with the full-arm plaster 65% of secondary dislocation occurred. In the group of 20 patients with the full-arm plaster and the X-ray done between the 7th and 10th day after reduction to correct possible dislocation, followed always by the new, similar plaster cast, we observed 40% of secondary dislocations. Whenever the full-arm plaster was used Sudeck syndrome was observed very rarely. No direct relationship between kind of plaster used and the degree of shortening of the radius length after healing of the fracture was found. Comminuted fractures and osteoporosis are in favour for secondary dislocations.

Adolescent↗
PubMedDate not supplied

[The treatment of loose diaphyseal fractures of the humeral diaphysis using the hanging cast method].

A personal series of loose diaphyseal fractures of the humeral diaphysis, treated with the hanging plaster case method, has been examined in order to assess results. These were positive in most treated cases, with a complication percentage comparable to that obtainable with other methods. Although it is not considered that the usual treatment of reduction and plaster cast thoraco-brachial immobilisation should be abandoned, it is considered that the hanging cast is an equally valid alternative in all cases in which the patient's general condition represents a contraindication to the application of a bulky chest-extended cast.

Adult↗
PubMed1975

Thromboembolic complications of cast immobilization for injuries of the lower extremities.

Six cases of thromboembolic complications in patients being treated with plaster cast immobilization for a variety of injuries to the lower extremity were encountered over a four month period on an Air Force orthopaedic service. These injuries, consisting of three ruptures of the tendo achillis, two fractures of the tibia, and a sub-talar dislocation of the foot, resulted in one death from pulmonary emboli and three other serious complications of pulmonary emboli. The literature on thromboembolic complications following lower extremity injuries (including information of pathogenesis, clinical characteristics and epidemiology of venous thromboembolism and the hazards of lowere extremity cast immobilization in an individual susceptible to his complication) suggests that prophylaxis against thrombosis should be instituted in high risk individuals who must undergo case immobilization for injuries to the lower extremity.

Achilles Tendon↗
PubMed1988

Treatment of scaphoid fractures with a removable cast.

Forty-four fractures of the scaphoid bone were treated with a short-term removable orthoplast cast and compared with 48 fractures treated with a conventional long-arm plaster cast. At the follow-up, there was no difference between the two treatment groups as regards nonunion or other sequelae. We conclude that the inconvenience of the treatment of scaphoid fracture and the need of physiotherapy can be reduced by using an orthoplast cast.

Carpal Bones↗
PubMed2006

Shape and size of dental arch--a five-year prospective study.

OBJECTIVES: The diagnostic procedure commences with the initial examination, during which a number of individual findings of the occlusion or malocclusion are clarified [1]. The objective is to describe the morphological and functional characteristics on each patient using specific guidelines, and then to provide a prognosis of the therapy. Upper and lower arch compression in first premolars and molars area was visible before treatment. METHODS: A special device (Czech technical university research prototype) was prepared for this purpose. The optical head contains a digital color camera. The front of the optical head consists of a removable prism which is put into the mouth. The findings can display live images from the camera, which can be archived on a PC. The device captured and geometrically calibrated images permitting comparison of several different dental casts. RESULTS: In the first part of this study 792 sets of study plaster casts were screened. Measurements of dental arch width between reference points of canines, first premolars and first molars were made: upper jaw: men: 3-3-35.1 mm (SE 0.13); 4-4-37.5 mm (SE 0.13); 6-6-48.1 mm (SE 0.19); women: 3-3-33.4 mm (SE 0.13); 4-4-35.6 mm (SE 0.15); 6-6-46.7 mm (SE 0.19). The second part concerns the group of 36 patients which is different from the 792 controls. There were studied changes between initial, post-treatment and post-retention alignment of upper and lower dental arch. CONCLUSIONS: Geometrically calibrated images help compare several different steps of the treatment and show a significant difference between patients before and after treatment.

Adolescent↗
PubMed1999

Management of the radial composite donor site: an orthopaedic opinion.

Maxillofacial and plastic surgeons have reported on the management of radial composite flap donor sites, but little reference is made to orthopaedic advice. Orthopaedic surgeons manage forearm injuries more often than other specialties and we thought that an orthopaedic consensus was long overdue. The composite radial donor site subsequently fractures in up to 43% of cases. There is no agreement on the optimal management of these difficult injuries and the patient is often referred for orthopaedic advice. Options include plaster-cast immobilization, internal fixation with either a plate or intramedullary nail, and external fixation. Bone grafting may also be required. A postal questionnaire, using two case histories including radiographs, was sent to 100 consultant orthopaedic surgeons in the UK asking how they would manage the donor site primarily and how they would manage a fracture at this site. Fifty-nine adequate replies were received. Generally, six weeks of immobilization in a plaster of Paris (POP) cast was considered sufficient for the initial management of the donor site. In the event of a fracture, internal fixation with a dynamic compression plate with or without a cancellous bone graft was the most common choice.

Bone Transplantation↗
PubMed1983

Unstable fractures of the distal end of the radius (transfixion pins and a cast).

Forty-five unstable fractures of the distal end of the radius were treated with transfixion pins and plaster cast. Thirty-seven patients were personally reviewed and an analysis of the results are presented in this paper. Scheck's point system was used to grade functional results; 81.1 per cent were classified as satisfactory (excellent and good) and 18.9 per cent unsatisfactory (poor) group.

Adult↗
PubMedDate not supplied

The nonsurgical treatment of fractures of the dens epistrophei.

The authors examined 25 fractures of the dens epistrophei treated conservatively by several methods in order to evaluate the most suitable treatment for this lesion. A Minerva plaster cast proved to be effective in the treatment of type III fractures, while the halo plaster system obtained the best results in type II fractures.

Adolescent↗
PubMed2001

William Hunter's casts of the gravid uterus at the University of Glasgow.

The Hunterian Collection at the University of Glasgow possesses 11 plaster casts showing the pregnant uterus. Three correspond to Plates I, IV, and VI of Hunter's The Anatomy of the Gravid Uterus Exhibited in Figures (1774), progressive stages of dissection of the same specimen. A further three casts show consecutive stages of dissection of a uterus containing a fetus presenting by the breech. The other specimens show a normal pregnancy at about 6 months, a normal full-term uterus with the fetal head becoming engaged, a breech presentation with placenta previa and the umbilical cord around the fetal neck, and an obstructed labor with distended bladder and colon. The 10 on display show realistic coloring and are mounted on black wooden stands. An 11th specimen, amateurishly painted, is not on display. The casts differ in their style; some show only the abdomen, pelvis, perineum, and thighs, others show the full torso. They also differ in the amount of detail shown. The first three casts show the cut femur and muscles at the transected ends of the thighs, also shown in some of the plates in the Gravid Uterus. Although these features enhance the artistic impact of both the engravings and the casts, the authors are unconvinced that Hunter deliberately used them to achieve this, as has been claimed.

Adult↗
PubMed1993

Retrospective study of fifth metatarsal fractures.

On the basis of the authors' results in treating avulsion fractures of the tuberosity, immobilization in a short leg weightbearing cast for 4 weeks is the preferred treatment. If still symptomatic at 4 weeks, some patients may require further immobilization for an additional 1 to 3 weeks. Rarely do these patients require surgery. In patients with these types of fractures, no angulation or displacement deformity was seen on x-rays, so open reduction was not warranted. Although the study does not strongly support the view that delayed healing of Jones fractures is associated with weightbearing cast treatment, the authors still tend to recommend treatment with a short leg nonweightbearing plaster cast for 6 weeks. Patients may not tolerate such treatment for this amount of time. To encourage better patient compliance, a minimum of 3 to 4 weeks in a nonweightbearing cast followed by 3 weeks in a weightbearing cast is recommended. Although open reduction was indicated in a few cases, all patients with Jones fractures, aged 20, 22, 24, 24, and 27 years, declined that option. Specifically, one patient had a delayed union of the Jones-type fracture (Fig. 4). In spite of being young and athletic, and thus at high risk for refracture, he decided against open reduction internal fixation and opted for prolonged casting.

Adolescent↗
PubMed1986

Intra-articular fractures of the distal end of the radius in young adults.

Intra-articular fractures of the distal part of the radius in young adults comprise a distinct subgroup of fractures that are difficult to manage and are associated with a high frequency of post-traumatic arthritis. The effect of residual radiocarpal incongruity after this fracture has not been investigated previously. A retrospective study of forty-three fractures in forty young adults (mean age, 27.6 years) was done to determine the components that are critical to the outcome. Treatment included application of a cast alone in twenty-one fractures, insertion of pins and application of a plaster cast in seventeen, external fixation in two fractures, and open reduction and internal fixation in three fractures. At a mean follow-up of 6.7 years, 26 per cent were rated as excellent; 35 per cent, as good; 33 per cent, as fair; and 6 per cent, as poor. There was radiographic evidence of post-traumatic arthritis in twenty-eight (65 per cent) of the fractures. Accurate articular restoration was the most critical factor in achieving a successful result. Of the twenty-four fractures that healed with residual incongruity of the radiocarpal joint, arthritis was noted in 91 per cent, whereas of the nineteen fractures that healed with a congruous joint, arthritis developed in only 11 per cent. A depressed articular surface (a so-called die-punch fragment) was reduced anatomically by closed means in only 49 per cent and was responsible for residual incongruity in 75 per cent of the incongruous joints at late follow-up. Non-union of the ulnar styloid process adversely affected the results. Restoration and maintenance (extra-articular reduction) of the dorsal tilt and radial length did not prove critical except when severe radial shortening occurred.

Adult↗
PubMed1987

Surgical versus nonsurgical treatment of ligamentous injuries following dislocations of the elbow joint.

Sixty-two patients older than 16 years of age at the time of injury were reexamined an average of five years (range, 1 to 12 years) after a dislocation of the elbow without concomitant fracture. Thirty-four were treated nonsurgically with closed reduction and immobilization in a plaster cast. Twenty-eight were treated surgically with primary ligament repair followed by immobilization in plaster. Ligament repair was performed medially in all cases and laterally in 17, on the average two days after injury. At follow-up examination, the most common complaint in both groups was limited range of motion, decreased extension being the most common. In no respect were the surgically treated elbows better than those treated nonsurgically. No evidence was found to recommend primary surgical treatment of ligament injuries associated with dislocation of the elbow.

Casts, Surgical↗
PubMedDate not supplied

Serial casting as a technique to correct burn scar contractures. A case report.

Serial casting is a fast, relatively simple, and inexpensive way to effectively correct burn scar contractures. Plaster casts provide circumferential pressure and a prolonged stretch to contracted tissue and cannot be removed by the patient. When casts are applied well and padded appropriately, there is little risk of pressure areas, since the casts are conforming and do not slip distally. Serial casting may be a successful alternative when low-force dynamic splinting cannot be sized small enough for a child, or when patient compliance is unreliable. A case study of a 2-year-old male patient with severe plantar-flexion contractures of the ankles is presented.

Ankle Joint↗
PubMed1992

CAD CAM trans-tibial temporary prosthesis: analysis and comparison with an established technique.

The purpose of this study was to evaluate the application of CAD CAM in the production of temporary trans-tibial prostheses. The CAD CAM system was assessed based on the number of socket attempts, number of prosthetic appointments, and temporary prosthesis rehabilitation time. These parameters were considered to be related to the quality of socket fit and were influenced by the entire interdisciplinary team including the patient. A concurrent prospective comparison between the CAD CAM system and an established fiberglass/pelite liner technique was also performed. Patients (n = 30), were fitted with either a conventional or a CAD CAM socket. Records were kept before and after discharge until the interdisciplinary team considered the patient ready for definitive prosthesis casting. After approximately 90 postoperative days, patients were deemed fit to proceed from their initial plaster cast prostheses to their temporary prostheses. The group fitted with conventional sockets had an in-patient rehabilitation phase of 10.5 +/- 15.0 days and required 2.9 +/- 1.1 prosthetic appointments. In-patients fitted with CAD CAM sockets required 5.1 +/- 1.8 appointments and were hospitalised for 23.6 +/- 15.0 days. The significantly increased rehabilitation duration and number of appointments (p = 0.01), were generally due to incorrect socket volume and/or inadequately modified relief/loading areas. In this study 67% of the patients fitted with CAD CAM sockets required at least one additional attempt. The clinical evaluation and modification of the temporary prostheses, including the decision to remake a particular socket, were carried out by the same prosthetist who cast the patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗