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At least 937 records · Page 52Linked to original sources
PubMed2000

Displaced tibial shaft fractures: a prospective randomized study of closed intramedullary nailing versus cast treatment in 53 patients.

Of 53 patients with unilateral, displaced and closed or grade 1 open tibial shaft fractures, 27 patients (group I) were randomized to treatment with an intramedullary nail and 26 patients (group II) to treatment with a plaster cast. 12 fractures in the latter group were considered stable enough for treatment with only a cast (group IIa), while 14 fractures in group II showed redisplacement during reduction under anesthesia or at 1 week follow-up. Therefore, these fractures were stabilized with cerclage or screws (group IIb), which was a prerequisite for continuing cast treatment. The mean time-to-union was 19 weeks for group I, and 25 weeks for group II. 6 patients in group I and 16 in group II had delayed union. The Nottingham Health Profile index scores on physical mobility, social isolation, work ability, and sexual life were significantly better in group I than in group II at 3 months after injury. Delayed union, malunion, and restricted range of motion at the ankle joint were common complications when these fractures were treated with a cast. We recommend intramedullary nailing for these fractures.

Activities of Daily Living↗
PubMed1986

Effect of short leg casting on ambulation in children with cerebral palsy.

The purpose of this study was to compare and analyze changes in ambulation between two groups of children with cerebral palsy, with and without short leg casting. Sixteen children with spastic cerebral palsy, aged 10 to 108 months, were assigned randomly to either a short leg casted group or an uncasted group. All children were tested by me, before and after 10 weeks of neurodevelopmental treatment, by recording an ink print ambulation pattern on a length of paper fastened to the floor. Measurements of stride length, stride width, foot angle, and footprint clarity were taken to quantify the ambulation patterns. The percentage of improvement in stride length, stride width, and foot angle was analyzed using a t test, and the percentage of improvement in footprint clarity was analyzed using the Mann-Whitney U test. An alpha level of .05 was assumed to determine whether the differences between groups were large enough to be statistically significant. A significant difference was found in the percentages of improvement in stride length between the two groups, although the other results were nonsignificant. Short leg casting appears to be valuable in the management of spastic hemiplegia, diplegia, and quadriplegia. Clinical observations included improvement in muscle tone, trunk control, and symmetry. These results constitute the first objective measure, using a control group, supporting the therapeutic value of short leg casting for children with cerebral palsy.

Casts, Surgical↗
PubMed1997

The effect of casting combined with stretching on passive ankle dorsiflexion in adults with traumatic head injuries.

BACKGROUND AND PURPOSE: Ankle plantar-flexion contractures are a common problem following traumatic head injury. Although serial casting is used to correct and prevent ankle plantar-flexion contractures, treatment efficacy has not been evaluated using an experimental design. The aim of this research was to establish the effect of a regimen of casting combined with stretching on passive ankle dorsiflexion motion. SUBJECTS: Nine people who had sustained traumatic closed head injuries and had limited dorsiflexion motion participated in the study. METHODS: A crossover design was used in the study. Subjects were assigned to both experimental and control groups. Torque-controlled measurements of passive ankle dorsiflexion motion were obtained for all subjects before and after 1 week of casting combined with stretching, as well as before and after a 1-week control period. The order of the experimental and control conditions was randomized. RESULTS: Passive ankle dorsiflexion increased by a mean of 13.5 degrees (SD = 9.3) during the experimental condition, as compared with a mean decrease of 1.9 degrees (SD = 10.2) during the control condition. The difference between the experimental and control conditions was statistically significant. CONCLUSION AND DISCUSSION: These findings suggest that casting combined with stretching is an effective method of correcting ankle plantar-flexion contractures in patients with traumatic head injuries.

Adolescent↗
PubMed1997

Plaster cast versus percutaneous pin fixation for comminuted fractures of the distal radius in patients between 46 and 65 years of age.

OBJECTIVE: To compare the results of treating unstable distal radius fractures either by percutaneous pinning and casting, or by traditional closed reduction and casting. DESIGN: Prospective, randomized. SETTING: University hospital. PATIENTS: Forty patients with unstable Frykmann III-VIII distal radius fractures resulting from a fall. INTERVENTIONS: Twenty patients were treated with closed reduction, consisting of manipulation, under local anesthesia, followed by casting. Twenty patients were treated with percutaneous fixation using K-wires, followed by casting. MAIN OUTCOME MEASUREMENTS: Initial displacement, quality of reduction, carpal malalignment, articular step-off. Range of motion and grip strength were measured using a scoring system reported by Home et al. (10). RESULTS: Functional results in the pinning group were better (excellent, 12; good, 6; fair, 2) than in the plaster group (excellent, 3; good, 8; fair, 5; poor, 4). Anatomic results also were better in the pinning group. CONCLUSION: The best anatomic and functional results were obtained by percutaneous pinning. Although the cost of pins and plaster treatment is significantly greater than plaster treatment, the author believes that the positive end result justifies the cost.

Aged↗
PubMedDate not supplied

Altering children's distress behavior during orthopedic cast removal.

The hypothesis treated was that discrepancy between expected and experienced physical sensations (what is felt, seen, heard, tasted, and smelled) during a threatening experience will result in distress. The subjects were 84 children, 6 to 11 years of age, male and female. The threatening experience was orthopedic cast removal. Tape recorded preparatory information was used to vary systematically expectations about physical sensations. The children were randomly assigned to one of three information groups: 1) sensory information which described the sensory experience during cast removal, 2) procedure information which described the steps of the experience, 3) control group which heard no tape recorded information. Nonverbal and verbal signs of distress reactions and the pulse rate were observed during cast removal. Signs of distress were scaled from zero to two, with zero meaning no distress behaviors and two, high distress behavior. A two-factor analysis of variance (two levels of pre-fear and three levels of information) was used for analysis. As hypothesized, the mean distress score for the sensation group (.50) differed significantly from the control group mean (1.00 p less than .025). The procedure group distress score mean (.71) fell between the sensation and control group means but did not differ significantly from the control group mean. The no pre-fear group distress score mean (.52) was significantly lower than the some pre-fear group mean (1.00 p less than .02). Mean pulse rate changes for information groups for before to during cast removal were in the same order as the distress scores, but the differences were not statistically significant. The findings were similar to those from other tests of the hypothesis.

Adaptation, Psychological↗
PubMedDate not supplied

Cast abscess: a case report.

This report describes a case in which a pediatric patient wounded his ankle when he stuck an object inside the cast while trying to scratch himself. The wound became infected and resulted in a limb-threatening abscess. Although most patients treated with casts do not have any significant problems, it is important to emphasize cast care instructions to young patients and their parents. In addition, it may be equally important to advise patients about safe methods to alleviate itching, such as blowing cool air under the cast. In this way, the risk of serious infectious complications can be minimized.

Abscess↗
PubMed2003

Functional and radiographic outcome of thoracolumbar and lumbar burst fractures managed by closed orthopaedic reduction and casting.

STUDY DESIGN: Retrospective review. OBJECTIVES: To determine clinical and radiographic outcomes of thoracolumbar and lumbar burst fractures without neurologic injury treated by closed reduction and casting. Patient factors associated with poor outcome are identified. SUMMARY OF BACKGROUND DATA: The results of ambulatory bracing, surgery, and prolonged recumbency for burst fractures have been reported. There are no reports of results of closed reduction and casting. METHODS: Retrospective review of 41 neurologically intact patients with thoracolumbar and lumbar burst fractures was performed. Four patients with neurologic injury who refused surgery were included, for a total of 45 patients. All patients had closed reduction and casting. Functional, pain, and employment status were assessed using the Denis system. Neurologic function was graded using the Frankel scale. Radiographic evaluation of vertebral kyphosis, regional kyphosis, anterior body compression, and sagittal index were performed at time of injury, postreduction, 4 months, and final follow-up. RESULTS: Sixty-four percent of patients had minimal or no pain. Eight percent had constant, severe pain. At time of injury, 71% of patients were employed. At 8-month follow-up, 58% of patients were employed. Closed reduction resulted in significant correction of vertebral wedging from a mean of 15 degrees to 5 degrees. Deformity tended to recur by 4 months, but the degree of residual deformity appears to be less than that reported in other series. No complications resulted from the fracture reduction procedure. CONCLUSIONS: Closed reduction and casting of thoracolumbar and lumbar burst fractures is a safe treatment method that yields acceptable functional and radiographic results.

Absenteeism↗
PubMed1981

Cast bracing of femoral shaft fractures in children: a preliminary report.

This paper reviews the use of cast bracing in fractures of the femoral shaft in children between 1977 at the Royal Aberdeen Children's Hospital. Thirteen children have been treated by cast bracing. All children have achieved a full functional recovery. The average time to cast bracing was 3 weeks, and the average time to discharge was 4 weeks. Thus treated, these children were discharged 4 weeks earlier than those treated by conventional measures. It was found that the technique of cast bracing was applicable to children with no adverse complications.

Braces↗
PubMedDate not supplied

Femoral shaft fractures in children treated with early spica cast.

We retrospectively reviewed 51 patients aged 3-11 years with femoral shaft fractures selected for treatment with early spica cast immobilization. Shortening greater than 20 mm was the most common complication, occurring in 22 (43%) of the 51 patients. Factors associated with unacceptable shortening were shortening at the time of spica cast application greater than 10 mm, shortening greater than 20 mm at initial examination, and increasing age. Achieving less than 1 cm shortening at the time of cast application and close follow-up during the first 2 weeks after cast application are advised in order to achieve an acceptable final outcome.

Casts, Surgical↗
PubMedDate not supplied

Short arm plaster cast for distal pediatric forearm fractures.

Ten years' clinical experience with below-elbow plaster cast treatment of distal one third pediatric forearm fractures was subjected to an independent retrospective radiographic review. In the study population of 761 fractures, no significant displacement occurred while the forearm remained in plaster. The average angulation change was 4.5 degrees (SD +/- 2.2 degrees). In each angulation change > 5 degrees, poor cast molding was evident, as reflected by a high "cast index" (p < 0.01). Although this technique is technically demanding, excellent results are obtained in all distal pediatric forearm fractures if proper cast molding is used.

Casts, Surgical↗
PubMed2004

Mechanical properties of cast Ti-6Al-4V-XCu alloys.

The mechanical properties of Ti-6Al-4V-XCu (1, 4 and 10 wt% Cu) alloys were examined. The castings for each alloy were made in a centrifugal titanium casting machine. Two shapes of specimens were used: a dumbbell (20 mm gauge length x 2.8 mm diameter) for mechanical property studies, and a flat slab (2 mm x 10 mm x 10 mm) for metallography, microhardness determination and X-ray diffractometry. Tensile strength, yield strength, modulus of elasticity, elongation and microhardness were evaluated. After tensile testing, the fracture surfaces were observed using scanning electron microscopy. The tensile strengths of the quaternary alloys decreased from 1016 MPa for the 1% Cu alloy to 387 MPa for the 10% Cu alloy. Elongation decreased with an increase in the copper content. The 1% Cu alloy exhibited elongation similar to Ti-6Al-4V without copper (3.0%). The results also indicated that the copper additions increased the bulk hardness of the quaternary alloy. In particular, the 10% Cu alloy had the highest hardness and underwent the most brittle fracture. The mechanical properties of cast Ti-6Al-4V alloy with 1 and 4% Cu were well within the values for existing dental casting non-precious alloys.

Alloys↗
PubMed1993

Effects of inhibitory casts and orthoses on bony alignment of foot and ankle during weight-bearing in children with spasticity.

One theory about the improvements in gait seen in children with CP who use inhibitory casts holds that they are a result of better posture of the foot. To examine this theory, the authors used x-rays to document the position of the foot both before and during inhibitory casting to see whether there were measurable changes in foot posture that could be ascribed to the casts. The bony alignment of the ankle and foot was compared during weight-bearing with the children in and out of inhibitory casts (N = 12), static ankle-foot orthoses (N = 7) and articulated ankle-foot orthoses (N = 8). The only angle change which was significant was calcaneal inclination in the articulated AFOs versus out of the orthoses. There was no significant difference in any of the other angles in any of the groups.

Adolescent↗
PubMed1998

Restoring the edentulous maxilla using an implant-supported, matrix-assisted secondary casting.

The selection of appropriate implant treatment modalities for the edentulous maxillary arch is complex. Although many patients are candidates for an implant-supported removable prosthesis, two major considerations affecting choice of treatment type are the amount of residual alveolar bone and soft tissue, and cost. A technique is described that employs a cast milled primary bar and a secondary casting constructed using a vacuum-formed 0.040-in plastic matrix. The secondary casting is intimately adapted to the primary bar and incorporates the retentive elements within it. The resulting prosthesis is less expensive than comparable designs, and retentive elements are easily replaceable. The technique is adaptable to most implant systems. The matrix-assisted secondary casting technique provides a design that is esthetic and hygienic. The prosthesis may also be easier to insert and remove than implant-supported removable prostheses that use plunger- or latch-type retention.

Alveolar Bone Loss↗
PubMed1997

Corrosion casts of the suprachoroidal space and uveoscleral drainage routes in the pig eye.

Eyes from pigs were studied by corrosion casting technique. Batson's mixture No. 17 (methyl methacrylate) was injected through a sclerotomy into the suprachoroidal space. Following polymerisation of the injected mixture the surrounding tissue was dissolved with 10% natrium hydroxide. Macroscopic and scanning electron microscopic findings in casts of the suprachoroidal space are presented. The outer (scleral) surface of the casts was rough, with a fish-scale-like appearance caused by fine lamellas between the sclera and choroid, running from the inner layers of the sclera traversing the space anteriorly to the choroid. Frequently, irregular, Y-shaped branches deriving from the outer surface of the casts were observed. They corresponded to the perivascular space of the vortex veins and represent a possible uveoscleral drainage route for aqueous humour.

Animals↗
PubMed2007

Cementable implant crowns composed of cast superstructure frameworks luted to electroformed primary copings: an in vitro retention study.

OBJECTIVE: The aim of this in vitro study was to investigate, on ITI solid abutments, the retention values of single crowns fabricated using an alternative prosthetic solution: secondary cast superstructure luted to an electroformed primary coping. MATERIALS AND METHODS: Fifty standard 4.1 mm ITI implants and 5.5 mm high ITI machined abutments were assembled and mounted in acrylic resin. Implant/abutment assemblies were randomly divided into two groups. In the test group, primary galvanic caps were directly fabricated on implant abutments (A.G.C. Micro machine), and a secondary cast noble alloy superstructure was luted on each primary galvanic cap with a resin cement (Nimetic Cem). In the control group, prefabricated burn-out caps were used for casting the metal frameworks. Test and control crowns were cemented using a resin cement (Panavia 21). After storage at 37 degrees for 24 h, the specimens were subjected to a pull-out test using an Instron universal testing machine. The load required to dislodge each sample and the respective mode of failure were recorded. Means and standard deviations of loads at failure were analyzed using ANOVA. Statistical significance was set at P< or =0.05. RESULTS: The retention values (+/-SD) of loads at failure were 67.26 (+/-16.61) for the test group and 44.03 (+/-9.45) for the control group. In the test group no separation occurred between the electroformed (galvanic) primary cap and the secondary superstructure. CONCLUSIONS: The results showed that this prosthetic solution is superior on retentive performance than the conventional cast framework. An added clinical advantage of this novel method is its potential to provide a totally passive fit. Further in vitro and in vivo studies involving multiple-unit restorations are needed in order to more generally validate this prosthetic concept.

Cementation↗
PubMed1984

The strain on sutured Achilles tendons in walking cast. An EMG analysis.

To evaluate the strain on a sutured Achilles tendon during walking in a short leg cast the EMG activity of the triceps surae muscles was studied. The regression line of the EMG/torque relationship of the triceps surae in the noninjured leg was investigated during isometric contractions with the foot in the same plantarflexed position as the injured foot immobilized in plaster cast. A linear relationship was found between EMG activity (EMG signals converted to rectified mean square values) and torque, measured with Cybex II. The torque provided by the triceps surae of the injured leg was calculated from the registered EMG activity during walking and the regression line. The strain acting on the sutured Achilles tendon was calculated after measurement of the lever arm. There was no significant difference in calculated strain on the sutured Achilles tendon during nonweight bearing in a short leg cast and full weight bearing without external rotation movement of the leg. External rotation movement of the leg during full weight bearing gave increased strain on the sutured Achilles tendon. The actual strain is considered somewhat lower than the calculated one since other muscles than the triceps surae contribute to plantar flexion of the ankle joint. The results indicate that the strain during weight bearing in a short leg cast is unlikely to exceed the strength of a sutured Achilles tendon.

Achilles Tendon↗
PubMed1979

Fit of porcelain fused-to-metal crown and bridge castings.

The dimensional accuracy of porcelain fused to metal crown and bridge castings was determined on truncated cone-shaped steel dies. Ni-Cr castings produced in manufacturers' laboratories were consistently undersize, while precious metal castings were consistently oversize. Ni-Cr castings, produced in NBS laboratories using a modified investing technique, were routinely oversize.

Chromium↗
PubMedDate not supplied

Hinged cast after knee ligament surgery.

One hundred thirteen patients scheduled for repair of knee ligament injuries were randomized to postoperative immobilization in either a hinged or a long leg cast. The time of disability (i.e., sick leave) was significantly shorter (6 weeks) with a hinged cast, but only in ACL cases. All types of injuries regained their range of motion more rapidly after use of a hinged cast. There was no evidence that the motion permitted in a hinged cast hampers the result as regards to stability.

Adolescent↗