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At least 955 records · Page 53Linked to original sources
PubMed2000

Total contact casting and Keller arthoplasty for diabetic great toe ulceration under the interphalangeal joint.

Interphalangeal (IP) ulcerations of the great toe are frequently encountered in neuropathic diabetic feet. While total contact casting is usually effective as a first line treatment, recalcitrant ulcers continue to present substantial management challenges. The authors retrospectively reviewed the results of Keller arthroplasty employed to accelerate ulcer resolution with total contact casting in fourteen patients with neuropathic ulcers under the great toe interphalangeal (IP) joint that were resistant to casting alone. These data were compared to a group of similar patients whose ulcers were successfully treated by non-operative measures. No operative complications were observed, and all ulcers healed within twenty-four days with no recurrence documented at an average follow-up of 26 weeks. In cases of resistant great toe IP plantar ulcers associated with hallux rigidus that have failed casting trials, this treatment method can be effective.

Adult↗
PubMed2002

Poor retention after closed reduction and cast immobilization of low-energy tibial shaft spiral fractures.

BACKGROUND AND AIMS: The aim of this retrospective study was to analyze retention in cast after closed reduction of low-energy two-fragment tibial shaft fractures. MATERIAL AND METHODS: The material consisted of 72 closed tibial shaft fractures AO/ ASIF type A treated with closed reduction and plaster cast. Fractures were subgrouped according to the AO/ASIF classification and the initial fracture displacement was measured. Final alignment and the frequency of operative intervention due to early loss of reduction were analyzed. RESULTS: 40% of all fractures lost reduction and were operated on. The largest subgroup was A1.2 fractures, a spiral tibial shaft fracture with a fibular fracture at another level. Out of the 28 fractures in this group 61% were converted from cast to early operative intervention. CONCLUSION: Closed reduction and cast treatment of spiral tibial shaft fractures AO/ ASIF type A1.2 had a high failure rate.

Adolescent↗
PubMedDate not supplied

Detachable functional focused rigidity cast for metatarsal fractures.

This article aims to assess whether a detachable functional focused rigidity cast can be used as a one-off definitive treatment for proximal 5th metatarsal fractures. A prospective trial was carried out over a 2-year period. Forty-one patients with proximal 5th metatarsal fractures (tuberosity and Jones) were recruited and treated with a detachable focused rigidity cast after appropriate consent. Of the 39 patients with follow-up, six had a Jones fracture and 33 had tuberosity fractures. All 33 patients with tuberosity fractures achieved clinical union within 4-5 weeks (mean of 4.2 weeks). Four of the six patients with Jones fractures achieved clinical union in 8-12 weeks. One achieved union in 14 weeks and one underwent open reduction and internal fixation for delayed union. There were no complications related to the cast. The results support the use of a detachable focused rigidity cast as a one-off definitive treatment of tuberosity fractures of the 5th metatarsal. However, all the Jones fractures and the diaphyseal fractures should be referred to an orthopaedic team for further management.

Adhesives↗
PubMed1977

The cast-brace treatment of femoral shaft fractures.

Ninety-eight fractures of the shaft of the femur were seen in one unit over the two years 1974 and 1975, and the results have been assessed in sixty-nine. Of these, thirty-eight were treated by skeletal traction in a Thomas's splint followed by skin traction, and thirty-one by skeletal traction followed by a cast-brace. The technique of application is described in some detail. The average time for application of the cast-brace was six weeks after the injury, the time in hospital eight weeks and the time till removal fifteen weeks. The patients selected for a cast-brace were in hospital for just over half the time of the others and their fractures on average united more quickly, though with some trouble from angulation of fractures of the uppermost third of the shaft. It is concluded that when used with all the judgment and skill it demands, the cast-brace method is a great advance in conservative treatment.

Braces↗
PubMed2000

Toe-walking in children younger than six years with cerebral palsy. The contribution of serial corrective casts.

Our aim in this retrospective study was to analyse the value of serial corrective casts in the management of toe-walking in children aged less than six years with cerebral palsy. A total of 20 children (10 hemiplegic and 10 diplegic) had elongation of the triceps surae by serial casting at a mean age of four years and one month. The mean passive dorsiflexion of the foot with the knee in extension was 3 degrees (-10 to +5) and 12 degrees (0 to +15) with the knee in flexion. After removal of the cast passive dorsiflexion was 20 degrees (+10 to +30) with the knee in extension, and 28 (+10 to +35) with the knee in flexion. At a mean follow-up of 3.08 years (2.08 to 4.92), passive dorsiflexion was 9 degrees (-10 to +20) with the knee in extension and 18 degrees (0 to +30) with the knee in flexion. Serial corrective casts are useful for the treatment of equinus in young children as the procedure is simple and the results are at least equal to those of other non-operative techniques. It is a safe alternative to surgical procedures especially in young children. If the equinus recurs operation can be undertaken on a tendon which is not scarred.

Ankle Joint↗
PubMed2001

Anxiety reaction in children during removal of their plaster cast with a saw.

We have had experience of an 18-month-old boy with a cardiomyopathy who died a few minutes after removal of his cast with a saw, apparently from a malignant cardiac arrhythmia triggered by anxiety. We therefore examined the anxiety reaction to this method of removal of a plaster cast in 20 healthy children; ten were provided with hearing protectors and ten were not. The level of anxiety was assessed by measuring the heart rate, a known physiological indicator of anxiety, before, during and five minutes after removal of the cast. The noise level was also measured. The results showed a mean increase in heart rate during the procedure of 27.9 beats per minute (bpm) (26.9%) in the children with no hearing protectors and 10.4 bpm (11.1%) in children who used hearing protectors (p < 0.001). Five minutes after the procedure the heart rate had returned to the baseline rate in all patients. We recommend that hearing protectors should be used in children undergoing removal of a plaster cast to decrease the anxiety reaction. If possible, clinicians should avoid the use of a saw for this purpose in children with a cardiomyopathy.

Anxiety↗
PubMed2004

[Investigation of influencing variables on the computer-aided simulation of contacts in dynamic occlusion based on optically digitized plaster casts].

In dentistry, mechanical articulators with which mandibular movements can be reproduced in dentals casts play a major role. Commonly used semiadjustable articulators, however, have major limitations: On the one hand, the movement of the mandible is not reproduced exactly, on the other, they do not provide time-related information on jaw movement. Both problems can be solved by replacing the mechanical articulator by a digital simulation ("virtual articulator") based on digitized plaster casts and electronically recorded masticatory movements. We present a system for the 3D measurement of plaster casts in a skull-related, anatomical coordinate system using the fringe projection technique, and electronically recorded condylar movements. Using numerical algorithms, the contacts between upper and low jaw, and the angle of rotation of the temporomandibular joint can be computed for each movement in dynamic occlusion. Taking the data recorded from a patient as an example, the influence of the accuracy of the digitization of plaster casts on the computation of the rotation of the temporomandibular joint is discussed in relation to the anatomy of the masticatory apparatus.

Computer Simulation↗
PubMed1998

Effects of repeated hand instrumentation on the marginal portion of a cast gold crown.

A study was conducted to evaluate the effects of repeated hand instrumentation on the marginal portion of a cast gold crown. Seven extracted periodontally diseased premolars were used. The finishing line of the preparation was placed on the root surface and then the crown was cast and cemented in the usual manner. One proximal surface of each sample was divided into 2 areas: root planing (RP) area and RP plus polishing (RPP) area. The marginal portion of the crown was measured to give a baseline value using a surface roughness- and profile-analyzing system. Then, the marginal portion was painted with a waterproof pen. RP was performed to remove paint in the RP area with the curets. In the RPP area, RP followed by polishing was done by silicone polishing points and a rubber cup with polishing paste. The relevant procedures and measurements were repeated 3 times in each area. Changes in the sample roughness and profile were evaluated and compared between the 2 techniques. The results showed that repeated instrumentation altered the surface of the marginal portion of the cast gold crown, resulting in increased roughness in both areas (P < 0.01). However, the roughness of the RPP area was considerably restored to the baseline value by polishing after RP. Therefore, it is suggested that polishing after RP smoothes the marginal portion of the cast gold crowns and appears to be an efficient prophylactic system.

Bicuspid↗
PubMed1989

Studies on the castability of Co-Cr alloy for cast plates. Part 1: The effects of sprue attachment direction to wax plates and the investment direction of refractory models.

Co-Cr alloy is used more frequently than Ni-Cr alloy as a non-precious alloy for cast plates in Japan. However, since the melting point of Co-Cr alloy is very high, about 1300 degrees C, and since it oxidizes easily, a vacuum-pressure casting machine capable of melting this alloy in a reduced atmosphere has recently been developed. Using this vacuum-pressure casting machine, the authors studied the effects on the Co-Cr alloy of the attachment direction of sprues and the investment direction of refractory models. The results clarified that in the vacuum-pressure casting method, sprue attachment direction and the investment direction of refractory models have a significant effect (p less than 0.01) on the castability of Co-Cr alloy.

Chromium Alloys↗
PubMed1994

Study on the castability of Co-Cr alloy for cast plates. Part 4. Effects of sectional area, number of sprues and alloy components on castability.

Co-Cr alloy is used more frequently than Ni-Cr alloy as a nonprecious alloy for cast plates in Japan. Titanium with good biocompatibility has often been contained in the composition of this Co-Cr alloy. However, since the melting temperature of Co-Cr alloy is very high, about 1300 degrees C, and it oxidizes easily, a vacuum-pressure casting machine capable of melting this alloy in a reduced atmosphere has recently been developed. In this study, using the vacuum-pressure casting machine, the possible effects of sectional area and the number of sprues attached to the cast plate wax pattern, as well as the alloy components, on the castability of three kinds of Co-Cr alloy containing titanium were examined. It was found that all of these parameters had significant effects on Co-Cr alloy castability.

Chromium Alloys↗
PubMedDate not supplied

Use of plaster casts in the management of diabetic neuropathic foot ulcers.

Neuropathic foot ulceration is a major medical and economic problem among diabetic patients, and the traditional treatment involves bed rest with complete freedom from weight-bearing. We have investigated the use of walking plaster casts in the management of seven diabetic patients with long-standing, chronic plantar ulcers. Although all ulcers healed in a median time of 6 wk, this therapy was not without side effects, which are described in detail. We conclude that casting is a useful therapy for neuropathic ulcers, although several clinic visits, including cast removal and foot inspection, are necessary to avoid potential side effects caused by the casting of insensitive feet.

Adult↗
PubMed1982

Casting and microstructure of post and core at different mold temperatures.

In the present investigation the microstructure and bonding between the wrought and cast elements of the post and core specimens were evaluated with respect to the preheating temperature of the investment. Clinically sized specimens were produced from one type III gold casting alloy in combination with two different wrought wire precious alloys. Preheating temperatures of 500 degrees, 600 degrees, 700 degrees, 800 degrees and 900 degrees C were employed. Microscopic evaluation of polished and etched transverse and longitudinal sections of the specimens indicated that recrystallization of the wrought wire was initiated at 700 degrees C for one type of specimen. The best reproduction of the wax pattern was obtained at 800 degrees C for post and core combinations. The union between the wrought and cast elements was, regardless of wire type, better in the core portion than in the post. The best union between cast and wrought structures was obtained with a non-oxidizing wire at 700 degrees C.

Chemical Phenomena↗
PubMed1981

Force and pressure recordings from patients with femoral fractures treated by cast-brace application.

Five patients with midshaft femoral fractures treated by early cast-brace application and ambulation were studied. With the patients in lying and standing postures, force transmitted through the knee hinges, ground reaction and pressure under the thigh cast were measured each week. When standing on the injured limb, the maximum load tolerated increased as the fractures healed and ranged from 39-61% body weight and 97-100% body weight at weeks two and eight respectively. In this posture in three cases, force transmitted across the knee hinges did not exceed 35% body weight or alter significantly throughout healing, the other two reached maxima of 67 and 60% body weight at week five and values decreased to less than 50% at week ten. By week six, each patient was transmitting significant force across the fracture (31, 12, 7, 36 & 55% body weight). Vertical force on the thigh cast due to rigid soft tissue containment was calculated to be between 3.6 and 10.8 X 9.8 Newtons throughout healing in all cases. Force transmitted through the knee hinges and pressure under the thigh cast, increased linearly as the injured limb was loaded.

Adult↗
PubMed1986

A comparative study of synthetic cast material strength.

The strength of five commercially available synthetic orthopedic casting products are discussed. Using three testing designs, significant differences could be consistently determined. These testing methods provide a means of comparing the various casting products on the market. The authors point out that this study was a comparison of ultimate strength only, and did not compare the other characteristics of the products. It also was noted that all these synthetic casting materials were stronger than plaster-of-Paris casting material.

Casts, Surgical↗
PubMed1997

Mechanical evaluation of a soft cast material.

In this study, the structural and material properties of a new semi-rigid material, Scotchcast SoftCast (SCS), were compared to the properties of two rigid materials, plaster of paris (POP) and Scotchcast Plus (SCP). Cylinders and flat beams made from 4, 6, 8, and 10 layers of each casting material were tested in three-point bending and diametrical compression. Initial stiffness and yield force values of SCS casts were significantly lower than for casts of SCP and POP made of the same number of layers. Casts made from SCS may be indicated for non-rigid applications, but not where rigid immobilization is required.

Calcium Sulfate↗
PubMed2000

New partition technique for two-chamber pressure casting unit for titanium.

Although titanium has been widely used in prosthetic appliances, such as cast removable partial denture frameworks, high quality castings are still difficult to obtain. This study proposes a new partition technique using a metal foil for improving castability of a two-chamber pressure casting unit. The metal foil was formed beforehand to bring it in contact with the mold crucible wall so that no clearance was left behind it. Using this formed foil, the mold cavity can be completely isolated from the upper chamber and can be maintained in a vacuum even after the rupture of the foil. Accordingly, a large casting force is generated very quickly, and as a result, castability is expected to be significantly improved. This expectation was confirmed by the experiments using wax patterns including thin plate and mesh plate.

Aluminum↗
PubMed1993

The efficacy of upper extremity inhibitive casting: a single-subject pilot study.

This pilot study was designed to examine the effects of short-term (48-hr) upper extremity inhibitive casting, with an encased thermoplastic splint, on problems related to upper motor neuron damage. The subject was an 8 1/2-year-old girl with left upper extremity spasticity. Three different measures were used: (a) rating of videotaped active movements of the child; (b) the Modified Ashworth Scale, a clinical measure of spasticity; and (c) The Biodex System, a measure of torque during passive elbow flexion and extension. After cast removal, subjective improvements were noted in the quality of active movement (through videotapes) and increased awareness and use of the casted hand by the child (through parents' reports). A trend toward decreased spasticity was demonstrated by the Modified Ashworth Scale and a statistically significant decrease in resistance to passive movement was shown by the Biodex recordings. However, this reduction in symptoms was temporary, lasting less than 3 days. The results of this study suggest that short-term inhibitory casting may prove efficacious in the treatment of the child with cerebral palsy, although further research is needed.

Casts, Surgical↗
PubMed1976

New fibreglass casting system in orthopaedic practice.

The composition, manufacture and application of a new fibreglass casting system for use in orthopaedic practice are described. The performance of the first 51 fibreglass casts used in routine fracture work is reviewed. The advantages (the cast is waterprof, extremely light and strong) and the disadvantages (an ultraviolet light source is required to cure the cast and the fiberglass tape is rather expensive) are evaluated.

Adolescent↗