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PubMedDate not supplied

Ponseti versus traditional methods of casting for idiopathic clubfoot.

Serial casting is successful in avoiding extensive posteromedial release (PMR) in only 11% to 58% of patients with idiopathic congenital clubfoot. Extensive open surgery is commonly associated with long-term stiffness and weakness. Ponseti claims to avoid PMR in 89% of cases by using his specific technique of manipulation, casting, and limited surgery. The authors report their first 27 patients undergoing the Ponseti technique (34 feet) with a group of 27 matched control patients (34 feet). All patients underwent serial casting, begun within the first 3 months of life. The parameter studied was the need to perform PMR within the first year of life. In the Ponseti group, only 1 (3%) of 34 feet required PMR. In 31 (91%) of 34 feet, percutaneous Achilles tenotomy was performed at age 2 to 3 months. The average duration of casting was 2 months. In the control group, 32 (94%) of 34 feet required PMR within the first year of life, despite a longer casting period. Based on the authors' initial success with the Ponseti method, they no longer believe that PMR is required for most cases of idiopathic clubfoot. Foot abduction splints are crucial to avoid recurrence. Longer follow-up will determine whether the authors can continue to match Ponseti's reported outcomes.

Case-Control Studies↗
PubMed2002

Application of a mixture of glycol polyethylenes for the preparation of microcorrosion casts--an observation.

Preparation of microcorrosion casts that can be used for observation in SEM is a laborious, time-consuming procedure. The authors paid particular attention to the process of dissection of the microcorrosion casts. This prompted the authors to reconstruct the plastic mass, produced by the firm Gurr (Great Britain) in the 1970s, which was used by them in previous research to immerse the cast in order to minimise the damage. By using easily obtainable polyethylene glycols, characterised by different physical and chemical features, in order to obtain smooth surface of the section, a low-toxic mixture was composed, which protected the microcorrosion casts sufficiently and did not interfere with the physical and chemical properties of the cast.

Cadaver↗
PubMed2003

The use of casts in the management of joint mobility and hypertonia following brain injury in adults: a systematic review.

Many controversies exist regarding the practicality, the theoretical premises, and the supporting evidence for the use of casts in the management of joint hypomobility and hypertonia (ie, increase in joint resistance to passive movement resulting from hyperactivity of the stretch reflex and/or changes in the muscles and connective tissues). The purpose of this review was to determine current best practice for the use of casting in the rehabilitation of adults with brain injury. A systematic review was undertaken to find studies that quantified the effectiveness of casting in adults with brain injury. Thirteen articles that presented experimental or case report evidence on casting were analyzed using Sackett's levels of evidence and were examined for scientific rigor. A grade B recommendation is given for the use of casting to increase passive range of motion or to prevent its loss, and implications for further research are provided.

Adult↗
PubMed2005

Bone mineral density during total contact cast immobilization for a patient with neuropathic (Charcot) arthropathy.

BACKGROUND AND PURPOSE: Diabetes mellitus (DM)-related neuropathic arthropathy of the foot is a destructive bone and joint process. The effect of cast immobilization and non-weight bearing on bone loss has not been well studied. The purpose of this case report is to describe the changes in bone mineral density (BMD) of the calcaneus in the feet of a patient with acute neuropathic arthropathy during total contact cast immobilization. CASE DESCRIPTION: The patient was a 34-year-old woman with type 1 DM, renal failure requiring dialysis, and a 7-week duration of neuropathic arthropathy of the midfoot. Intervention included total contact casting and minimal to no weight bearing for 10 weeks, with transition to therapeutic footwear. Ultrasound-derived estimates of BMD were taken of both involved and uninvolved calcanei. OUTCOME: Bone mineral density decreased for the involved foot (from 0.25 g/cm(2) to 0.20 g/cm(2)) and increased for the uninvolved foot (from 0.27 g/cm(2) to 0.31 g/cm(2)) during casting. DISCUSSION: The low initial BMD and further loss during casting suggest the need for transitional bracing and a well-monitored return to full activity to minimize the risk of recurrence and progression of foot deformity.

Adult↗
PubMed2005

Comparing botulinum toxin A with casting for treatment of dynamic equinus in children with cerebral palsy.

The purpose of this study was to compare the cumulative efficacy (three treatment sessions) of botulinum toxin A (BTX-A) alone, casting alone, and the combination of BTX-A and casting in the management of dynamic equinus in ambulatory children with spastic cerebral palsy (CP). Thirty-nine children with spastic CP (mean age 5y 10mo, range 3 to 9y) were enrolled in the study. A multicenter, randomized, double blind, placebo-controlled prospective study was used. Children were randomly assigned to one of three treatment groups: BTX-A only (B), placebo injection plus casting (C), or BTX-A plus casting (B+C). The dosage for the BTX-A injections was 4U/kg per extremity. Assessments were performed at baseline, 3, 6, 7.5, and 12 months with a total of three treatments administered after the evaluations at baseline, 3, and 6 months. Primary outcome measures were ankle kinematics, velocity, and stride length. Secondary outcome measures were ankle spasticity, strength, range of motion, and ankle kinetics. Group B made no significant change in any variable at any time. Groups C and B+C demonstrated significant improvements in ankle kinematics, spasticity, passive range of motion, and dorsiflexor strength. Results of this 1-year study indicate that BTX-A alone provided no improvement in the parameters measured in this study, while casting and BTX-A/casting were effective in the short- and long-term management of dynamic equinus in children with spastic CP.

Ankle Joint↗
PubMed2006

Waterproof versus cotton cast liners: a randomized, prospective comparison.

Casting injured extremities can cause complications (eg, itching, odor, rashes, skin maceration), many of which are associated with the inability to wash the extremity because of water retention and slow drying of conventional cast liners. A waterproof cast liner allows casts to become wet and perhaps improves hygiene and comfort. Fifty-nine patients (age, > or = 10 years) with upper or lower extremity injuries were randomized to a waterproof-liner group (n = 29) or a cotton-liner group (n = 30). Both groups had casts made of fiberglass tape. At each clinic visit, patients and physicians completed questionnaires evaluating comfort and skin condition, respectively. The waterproof-liner group had better scores for itch (P = .008), discomfort (P < .001), irritation (P = .002), overall patient score (P = .012), and overall physician score (P = .049).

Adolescent↗
PubMed2006

[Non-invasive detection of metal casting defects using dental X ray machine].

PURPOSE: The purpose of this in vitro study is to find the best parameters in detecting the casting defects made of titanium, nickel-chromium and chromium-cobalt using dental X ray machine. METHODS: Casting sheets in different thickness (1.0 mm, 0.6 mm, 0.3 mm)were fabricated using of Ti, Ni-Cr and Cr-Co.Small pores on the surfaces were made with laser welder to simulate the internal porosity of the castings. Parameters of the dental X ray machine were adjusted to take films. The data were analyzed using SPSS12 software package for group t test. RESULTS: The thickness of Ti had no significant effect on the setting of the parameters of the dental X ray machine in detecting the defects of titanium castings (P>0.05), while the thickness of Ni-Cr and Cr-Co had significant effect on the setting of the parameters (P<0.05). CONCLUSION: Dental X ray machine can be used in detecting the defects of titanium casting sheets.

Chromium Alloys↗
PubMed2006

[A comparison between the cast-bonded keeper with different dental alloys in the metallographic structure].

PURPOSE: The aim of this study is to investigate the changes of the metallographic structure of the cast-bonded keeper when cast in varied temperatures. METHODS: Three groups were included in this study: the gold alloy group, the Ni-Cr alloy group and Ti group, with the Magdisc 500 keeper as the control group. Each sample that contained a Magdisc 500 keeper was fabricated with the cast-bonded technique. Then, the samples were fabricated into a metallographic sample by polishing, smoothing and cleaning. Each sample was observed under metallographic microscope. RESULTS: There were no significant changes in the crystal size between the keeper in the gold alloy group and that in the control group. In both of the Ni-Cr alloy group and Ti group, the crystal of the keeper became larger, and this was more evident in the latter group. CONCLUSION: The keeper varied in the metallographic structure if cast-bonded with gold alloy, Ni-Cr alloy or Ti metal. The higher the casting temperature, the larger the crystal of the keeper. The results suggest that the change in the gold group is less than that in the Ni-Cr alloy group and Ti metal group.

Chromium Alloys↗
PubMed2006

[Treatment of pediatric femur fractures by immediate reduction and spica cast application--clinical and economical feasibility in the Israeli medical system].

BACKGROUND: Pediatric femur fractures are common injuries necessitating immediate application of spica cast or surgical stabilization. Currently, neither conservative nor operative fixation shows superior results; nevertheless, operative intervention has become more common lately. The current study retrospectively investigates short term results of immediate spica cast application, as well as the economic consequences of this treatment. METHODS: All cases of pediatric (6 months - 6 years) femur fractures treated in a single medium-sized hospital during 3 years were reviewed. Characteristics of fracture treatment and economical aspects were analyzed. RESULTS: Twenty four patients (17 boys and 7 girls, mean age 2.5 years, range 9 months to 5.5 years), were treated during the study period by immediate closed reduction and spica cast application. Eleven patients were also treated for medical reasons. All cases achieved acceptable alignment and shortening after cast removal. Two patients were re-admitted to the hospital Emergency Room but no changes in treatment were needed, one patient needed re-reduction. Mean hospital stay was 2.75 days. Calculated cost of such treatment is estimated to be almost equal to the compensation given by insurance companies (based on hospital stay in Israel). CONCLUSIONS: Immediate application of spica cast for pediatric femur fractures, achieves its goals of appropriate fracture-alignment and acceptable complication rates. The authors believe that the compensation should be procedure-based and not hospital-stay based, in a way that will encourage higher efficacy of medical treatment and shortened hospital stay.

Casts, Surgical↗
PubMed1991

Nonprecious cast-metal alloys in dentistry.

This review of selected articles from October 1989 to October 1990 is divided into two sections: a review of clinical studies and a review of laboratory studies for nonprecious cast metals. The clinical articles are centered on biological compatibility issues, such as taste anomalies (dysgeusia) attributed to cast metals and allergy correlation to base metals, and on technique and longevity evaluations involving resin-bonded fixed partial dentures. Laboratory articles are mainly devoted to metal preparation before bonding of etched or resin-bonded fixed partial dentures and the estimated bond strengths of the metal castings. Other selected articles are based on studies of physical properties and physical testing of nonprecious alloys, such as modulus of rupture, to determine ceramic compatibility, castibility testing, marginal fit of fixed partial dentures, and flexure testing of of traditional and experimental designs for cast major connectors. Additionally, a low-cost method of titanium casting is reviewed.

Biocompatible Materials↗
PubMed1990

[Surface roughness of high copper alloys as a function of heating above casting temperature].

Being the surface roughness a fundamental property in the fit of the castings, it was determined the roughness of 5 high-copper casting alloys, according to the heating over their melting temperature. That way, the specimens made with smooth plastic in the shape of a rectangular plate, 2 mm x 7 mm x 11 mm were invested into a cristobalite investment. After heating and elimination on the plastic, the molds were filled by 3 g of molten alloy, casted in a electrical casting machine at the casting temperature at 25 degrees C and 50 degrees C overheating. The surface roughness was measured in a roughness analyser, Talysurf. As a result, it was verified that there is a variation of surface roughness among the alloys tested, and the heating of the alloys until 50 degrees C over the melting temperature does not interfere in the roughness.

Copper↗
PubMed1990

[Angle reproducibility and surface roughness of stone casts obtained from combined agar-alginate impressions].

Angle reproducibility and surface roughness were compared among stone casts obtained from two agar-alginate impression methods; 1) conventional method in which an alginate mix was applied before gelation of agar, and 2) improved method in which an alginate mix was applied to gelled agar. Impressions of the rectangular parallel piped metal mold with a high accurate point angle was taken according to the above methods, and stone casts were obtained. Enlarged images of the angles of the casts were projected with an optical projector, and the defects of the point angle were traced. The area, the length and the circular-degree coefficient of the defects were determined using an image analysis system. The surface roughness of the stone casts was also measured. The stone casts prepared by the improved agar-alginate method had better angle reproducibility and the same surface roughness as that prepared by the conventional method.

Agar↗
PubMed1990

Treatment of slipped capital femoral epiphysis. Spica-cast immobilization.

Thirty-two patients (thirty-seven hips) who had a so-called acute-on-chronic or chronic slipped capital femoral epiphysis were treated with traction for relief of symptoms and then with immobilization in a spica cast for eight to sixteen weeks. The disappearance on radiographs of a metaphyseal juxtaphyseal radiolucency, rather than closure of the physis, was used as the criterion for removing the cast. In one (3 per cent) of the thirty-seven hips, the slip progressed; possibly this could have been prevented by keeping the cast on for a longer period of time. Narrowing of the cartilage space was seen after treatment in a cast in seven (19 per cent) of the thirty-seven hips. In five of these seven hips, this was true chondrolysis; in one, the diagnosis of chondrolysis had been apparent before treatment. Avascular necrosis did not develop as a result of treatment in any patient. Treatment in a spica cast should be considered as an alternative for patients who have an acute-on-chronic or chronic slipped capital femoral epiphysis.

Adolescent↗
PubMed1989

[Influence of the sprue casting design on the surface porosity of the silver-palladium dental alloys].

The purpose of this work is to investigate and find out the best "design" of the casting sprues on the area and the number of the surface porosity when we cast silver-palladium dental alloys for metalloacrylics fixed partial dentures. Our observation and research have been done on 216 external surfaces from 72 M.O.D. specimens, which were casted using four different designs of casting sprues and three types of silver-palladium dental alloys (Panag, Pangold and Palliag M.). The evaluation of our findings and statistical analysis have been done. The findings of our study are the following. 1. It has been found that the "alloy" factor doesn't influence the area and the number of the surface porosity we examined, on the contrary it has been found that the "design" factor has great influence on the area and the number of the dental alloys. 2. The use of chill-sets and the securing of sprue button alloy decrease the area and the number of the surface porosity when we cast silver-palladium dental alloys. 3. The straight sprues and the placing of the specimens near the heat-center of the mold created much better conditions for decreasing the number and the area of the surface porosity than when we use the preci-roto system.

Dental Alloys↗
PubMed1989

The cast brace and tibial plateau fractures.

Three hundred six tibial plateau fractures treated at the authors' institutions and in private practice were analyzed in relation to the use of a cast brace or fracture brace. One hundred forty-one of these patients had had a cast brace or fracture brace as part of their treatment program, either as the primary fracture treatment or after open reduction or traction. The aims of this study were (1) to determine if cast bracing could maintain alignment, fracture position, and range of motion and (2) to compare its results with those of other major long-term studies of similar fractures. There were 85 lateral, 24 medial, and 32 bicondylar fractures. Cast bracing was used for one to 17 weeks, with a mean of eight weeks. Ninety-nine of the 141 patients were followed for at least one year. Eighty-two of the patients maintained alignment with less than 5 degrees of deformity, and fracture position was maintained in 85% of cases, with only 15% having 4-8 mm of loss of position. Medial plateau and subcondylar fractures had an increased incidence of fracture position loss. Ninety-seven percent of patients had greater than 90 degrees of flexion, and 90% had full extension, i.e., less than 5 degrees of contracture. Pain was minimal or absent after heavy exercise in 90% of patients using cast bracing. Arthritic changes on roentgenographic analysis were absent or mild in 93.5% and moderate or severe in 6.5% of patients. Complications, including phlebitis, pulmonary emboli, wound infection, hardware slippage, and skin slough, occurred in nine patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Alternatives to high noble dental casting gold alloys type 3. An in vitro in vivo study.

For economic reasons a large number of cheaper alternatives to the high noble dental casting gold alloys have been introduced on the market. The main problem with these alternative alloys is their chemical stability. This is a most important property as degradation of an alloy may release substances which can be harmful to the wearer. Thus, the corrosion behavior of four dissimilar alternative dental casting alloys together with a high-gold reference alloy was evaluated in the as-cast, hardened, and annealed conditions by means of potentiodynamic polarization analysis, partly supplemented by electron spectroscopy for chemical analysis. In order to facilitate interpretation of the results of the corrosion study, the composition and metallographic structure of specimens in the specimens in the dissimilar conditions had to be determined. The methods used were light microscopy, electron probe microanalysis, and X-ray diffractometry. Biocompatibility, which is related to the release of metal ions, was evaluated by subcutaneous implantation of specimens from the five alloys in guinea-pigs. Thus, the in vivo toxicity of the different alloys could be assessed. The chemical stability of an alloy also determines its tarnish resistance and as tarnish apart from creating esthetic problems, also may result in changes in the wetting characteristics of the alloy surface the in vivo tarnish of as-cast and annealed specimens inserted into complete mandibular dentures was estimated after up to 16 weeks. Castability, an important factor in an alloy's clinical performance, was measured as the marginal sharpness of cast simulated crowns from the five alloys. Finally, the clinical performance of crowns and bridges made from one low-gold and one silver-palladium alloy as experimental materials together with a high-gold alloy as a reference material was evaluated using specific periodontal parameters, a tarnish index, and CDA's guidelines for the assessment of clinical quality. The findings may be summarized as follows: The metallographic evaluation for the low-gold alloys Midas and Rajah indicated that these alloys may contain more than one phase. The two silver-palladium alloys Albacast and Alba V were heterogeneous in the three conditions studied. In most cases, the pre-treatment of the alloys had a decisive influence on their proneness to corrosion. The castability of the silver-palladium alloys was inferior to that of the gold-based alloys. The biocompatibility as revealed by subcutaneous implantation showed that one of the silver-palladium alloys (Albacast) produced the least tissue response, while the other one (Alba V) exhibided the worst tissue response.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗
PubMed1978

[Precision in fixation and remounting of cast parts].

The exactitude of transferring castings was tested in two currently used methods of casting. Results showed that alginate casting from a remontage matrix and simple casting with IMPREGUM are sufficiently exact for clinical purposes. When the mixing relations between the casting substances is exactly maintained a transfer exactitude of +/- 0.11 is achieved by the methods tested. When there is a change in the relationship of the mixtures deviations of up to 0.20 mm occur.

Alginates↗
PubMed1979

[Casting of dental alloys with special reference to the bonding capacity of Ni-Cr alloys].

A short review on castability of dental alloys -- for which a definition is proposed -- reflects the different factors influencing the results of a casting. In this case solid sieves and plates are cast by use of one gold-base alloy (Type III) and two base metal alloys used for porcelain veneering. All three alloys filled the sieve pattern to a 100%, whereas they performed differently when cast as thin, solid squares. The most continuous results were achieved with a Ni-Cr-alloy whose melting temperature can be recognized since the ingots flow together when this point is reached. Since the plate pattern is most difficult to cast due to surface to bulk ratio it is assumed that a complete casting can only be achieved when the performance of the alloy is good and all required conditions match. Thus, this type of test seems to be suitable to determine the castability of a dental alloy. The sieve test should be used to investigate and to improve the influence of the different factors as for example burnout time and temperature of the mold and sprue size.

Chromium↗