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At least 1,711 records · Page 95Linked to original sources
PubMed2003

CIR sand casting system for trans-tibial socket.

The authors have developed a trans-tibial socket fabrication system based on the "dilatancy" principle, a process that has been commonly used in forming wheelchair Seating. The CIR Sand Casting System replaces plaster of Paris with sand for forming both a negative sand mould and a positive sand model, which can be modified for either thermoplastic socket formation or resin lamination. Initial clinical trials suggest that fabrication times are approximately 90 minutes from patient evaluation and casting to dynamic alignment. Compatibility with all existing prosthetic components is retained. It is believed the CIR socket fabrication system may be a competitive alternative for prosthetic service providers in developing countries.

Amputation, Surgical↗
PubMed1997

Internal fixation of hip osteotomy in children. Successful healing in 26 children without postoperative casting.

We assessed the necessity of postoperative casting when a plate was used for fixation of a proximal femoral varus osteotomy. 26 children without postoperative immobilization were compared to 17 children with a cast. No complications were encountered in either group of children and all osteotomies showed similar healing. Our findings indicate that plate fixation provides adequate stability for healing of the osteotomy.

Bone Diseases, Developmental↗
PubMed2003

Vascular system of intramural leiomyomata revealed by corrosion casting and scanning electron microscopy.

BACKGROUND: The vascular system of leiomyomata, the most common benign tumours in women, is an important factor controlling development and growth of the tumour. It has not been, however, investigated morphologically using the best currently available technique, corrosion casting combined with scanning electron microscopy. METHODS: Myomatous uteri collected upon autopsy were perfused via afferent vessels with fixative followed by Mercox resin and corroded after polymerization of the resin. The obtained vascular casts visualizing all vessels including capillaries were examined using scanning electron microscopy. RESULTS: The smallest (1-3 mm) fibroids were avascular, in larger ones (<1 cm) a few small vessels invaded the lesion from the periphery. The largest tumours (>1 cm) contained irregular networks of blood vessels with density similar to or lower than that of normal myometrium. Such tumours were surrounded by an extremely dense vascular layer ('vascular capsule') which was the source of larger vessels supplying and draining the tumour. CONCLUSIONS: During development of leiomyoma, the pre-existing blood vessels undergo regression and new vessels invade the tumour from the periphery, where intense angiogenesis, probably promoted by growth factors secreted by the tumour, leads to the formation of a 'vascular capsule' responsible for supply of blood to the growing tumour.

Adult↗
PubMed1987

Diabetic plantar ulcers treated by total contact casting. A clinical report.

The purpose of this clinical report is to describe the healing times of plantar ulcers treated by total contact casting (TCC) in nondiabetic and diabetic patients with and without evidence of severe peripheral vascular disease. Thirty patients with 33 chronic plantar ulcers were treated by applying total contact walking casts. Results demonstrate that 27 of 33 ulcers (81.8%) healed in an average time of 43.6 days. Healing times of patients with severe peripheral vascular disease secondary to diabetes mellitus are similar to those of patients without evidence of vascular disease. These results indicate that TCC is an effective and rapid treatment for chronic plantar ulcers in patients with or without vascular compromise secondary to diabetes mellitus. In addition, the results suggest that pressure reduction on the insensitive foot should be considered in treatment.

Casts, Surgical↗
PubMed1988

Splints and casts. Managing foot deformity in children with neuromotor disorders.

This article presents methods by which physical therapists can use splints and casts to intervene directly in pediatric foot deformity management, preprescription evaluation, rehabilitation, and new splint designs for children with neuromotor disorders. Recent advances in biomechanics, engineering, and orthotics have introduced new methods of preventing or reducing foot deformity while facilitating optimal function. Several splint styles are described with current indications and contraindications for their use. The use of casts in serial applications to reduce soft tissue contracture rather than to reduce muscle tone is discussed.

Casts, Surgical↗
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↗
PubMedDate not supplied

Gait patterns after fracture of the femoral shaft in children, managed by external fixation or early hip spica cast.

The authors prospectively studied three-dimensional kinematics and kinetics of gait in children recovering from a closed, isolated, nonpathologic fracture of the femoral diaphysis, who had been randomly assigned to management by monolateral external fixation or early hip spica casting. The aims were to investigate the gait patterns soon after injury and at 2 years after injury. Children treated with external fixation, walking with the external fixator in situ, demonstrated asymmetric gait abnormalities in all three anatomic planes affecting the trunk, pelvis, hip, knee, and ankle. This appears to be a strategy to minimize movement and pain at the fixator pin sites. The gait pattern normalized rapidly after removal of the external fixator with few kinematic or kinetic abnormalities and no clinically significant disturbances of gait at 2 years after injury. In contrast, children in the early hip spica cast group developed a "crouch gait" pattern in the sagittal plane, most likely due to weakness. They also had abnormal coronal plane kinematics related to shortening of the injured side. Gait patterns improved, but at 2 years there were some persistent gait deviations, probably related to residual limb length discrepancy.

Biomechanical Phenomena↗
PubMed1975

Ambulatory treatment of femoral shaft fractures with cast-brace.

Our early results support use of the cast-brace, early ambulation treatment of both open and closed fractures of the femoral shaft in all adult age groups. We believe initial traction should be used to reduce the fracture and maintain reduction until the fracture is clinically "sticky" to avoid subsequent malalignment in the cast-brace. The method facilitates early rehabilitation of the fractured extremity and the patient with minimal residual disability such as non-union, malunion, chronic infection and joint stiffness, so often associated with other forms of long bone fracture treatment.

Adolescent↗
PubMed2005

Femoral neck fracture in a child with autosomal-dominant osteopetrosis: failure of spica cast treatment and successful outcome by internal fixation.

A case report of a 6-year-old child with autosomal dominant osteopetrosis who sustained a closed femoral neck fracture initially treated with a spica cast with subsequent fracture displacement is presented. Further treatment included closed reduction and operative fixation, first, with a guide pin placement for a cannulated screw insertion that was abandoned because of the hardness of the bone. Three Kirschner wires were then inserted to maintain the closed reduction, followed by immobilization in a spica cast. At the 2-year follow-up, the child was completely free of any complications resulting from her injury and treatment. Radiographs showed no evidence of avascular necrosis in the affected femoral head. Review of the literature supports evidence for early operative fixation of such cases, whether or not the femoral neck fracture is nondisplaced or displaced.

Casts, Surgical↗
PubMed2006

A randomized, controlled trial of distal radius fractures with metaphyseal displacement but without joint incongruity: closed reduction and casting versus closed reduction, spanning external fixation, and optional percutaneous K-wires.

OBJECTIVES: To compare closed reduction and casting with closed reduction and external fixation with optional K-wire fixation for distal radius fractures with metaphyseal displacement but without joint incongruity. DESIGN: Prospective study. SETTING: Multicenter study at 3 University teaching hospitals. PATIENTS/PARTICIPANTS: A total of 113 skeletally mature patients with distal radius fractures with metaphyseal displacement, but without joint incongruity, were randomized to receive 1 of 2 standardized treatment protocols. Patients were evaluated at 6 weeks, 6 months, 1 year, and 2 years. INTERVENTION: Closed reduction and casting (n = 59) or closed reduction and external fixation (n = 54). MAIN OUTCOME MEASUREMENTS: Upper extremity function was measured using upper extremity MFA domain scores, overall Jebsen Taylor scores, and pinch and grip strength tests. Global function and pain were measured using the SF-36. Radiographic evaluation and range of motion were documented. RESULTS: Upper extremity MFA scores, Jebsen Taylor scores, SF-36 bodily pain scores, and grip strength improved significantly during the first year for all patients. By 2 years, mean Jebsen Taylor scores and SF 36 bodily pain scores for patients in both groups were similar to scores for normal age- and gender-matched population controls. At all points, there was a trend for better function in the external fixation; however, this did not reach statistical significance. There was a trend for better length and palmar tilt restoration with external fixation. CONCLUSIONS: For distal radius fractures with metaphyseal displacement but with a congruous joint, there exists a trend for better functional, clinical, and radiographic outcomes when treated by immediate external fixation and optional K-wire fixation.

Adult↗
PubMedDate not supplied

Use of the foot abduction orthosis following Ponseti casts: is it essential?

The purpose of this study was to evaluate the need for the use of a foot abduction orthosis (FAO) in the treatment of idiopathic clubfeet using the Ponseti technique. Forty-four idiopathic clubfeet were treated with casting using the Ponseti method followed by FAO application. Compliance was defined as full-time FAO use for 3 months and part-time use subsequently. Noncompliance was failure to fulfill the criteria during the first 9 months after casting. Feet were rated according to the Dimeglio and Pirani scoring systems at initial presentation, at the time of FAO application, and at 6 to 9 months of follow-up. At the time of application, no significant differences in scores were found between the groups. At follow-up, the compliant group's scores were significantly (P < 0.01) better than those of the noncompliant group. From the time of application to follow-up, for the compliant group, the Dimeglio scores improved significantly (P = 0.005). For the noncompliant group, the Dimeglio scores deteriorated significantly (P = 0.001). The feet of patients compliant with FAO use remained better corrected than the feet of those patients who were not compliant. Proper use of FAO is essential for successful application of the Ponseti technique.

Casts, Surgical↗
PubMedDate not supplied

Cast immobilization versus percutaneous pin fixation of displaced distal radius fractures in children: a prospective, randomized study.

Thirty-four patients were enrolled in a prospective randomized study comparing cast immobilization alone versus percutaneous pin fixation following closed reduction of distal radial metaphyseal fractures. Patients older than 10 years of age with greater than 30 degrees of dorsal angulation or with complete fracture displacement were eligible for enrollment. Average follow-up was 10.5 weeks. All fractures healed uneventfully without deformity, growth arrest, or functional limitations. Overall complication rates were similar between groups. Thirty-nine percent of patients treated with casting had subsequent loss of reduction requiring remanipulation; there were no cases of loss of reduction in patients treated with pin fixation. Thirty-eight percent of patients treated with pin fixation had pin-related complications; all resolved following pin removal without long-term sequelae. Cost analysis showed no significant difference in treatment charges between groups. Treating surgeons should be aware of the potential short-term complications of each treatment method and adjust their postoperative care appropriately.

Bone Nails↗
PubMed2006

A cast metal core for a deformed implant body: case report.

The present report consists of a clinical evaluation of an osseointegrated implant using a cast metal core instead of abutment for a deformed implant body. The intramobile connector insert for the implant in the mandibular left first premolar region broke 7 years after the superstructure was attached to the implant system. The intramobile connector insert was replaced, and the prosthesis was reattached, but the new intramobile connector insert broke again 2 weeks later. A thorough examination confirmed deformation of the upper section of the implant body in the mandibular left first molar region. Breakage of the new intramobile connector insert in the mandibular left first premolar region was believed to be due to deformation of the implant body in the mandibular left first molar region. Therefore, a cast metal core was used to deal with the deformation of the implant body in this region. Although slight bone resorption was observed around the implant body after 5 years, no major problems were found in the implant body itself.

Adult↗
PubMed1983

Ringworm resulting from swimming with a polyurethane cast.

A case of ringworm of the arm is described in a 6-year-old child, after swimming with a polyurethane cast. This report illustrates a potential problem when these casts are inadequately dried and worn for prolonged periods in warm climates. Accurate diagnosis depends on demonstration of fungus in the lesion by smear and culture. Topical antifungal therapy led to rapid resolution.

Casts, Surgical↗
PubMed1983

Cast brace management of the femoral shaft fracture in children and young adults.

Seventy-two children and adolescents, 5-19 years of age, sustaining femoral fractures were treated with immediate cast bracing at Oklahoma Children's Memorial Hospital. Ambulation was started an average of 3 days after fracture when there were no associated injuries. The average length of hospitalization was 18.7 days; the average length of immobilization in plaster was 67.4 days. Results were generally comparable to those of more standard methods of treating a fractured femur in this age group. Proximal as well as middle and distal fractures were treated, but varus and anterior angulation was not well controlled in proximal fractures. No patient had a clinically significant deformity. Sixty-one percent of the entire group healed with less than 6 mm discrepancy. Middle-third fractures showed more tendency toward shortening. All six fractures that healed with more than 1.5 cm of shortening were middle third. No injured femur was longer than the uninjured femur at a 6-month follow-up. Immediate cast bracing can provide an opportunity for early ambulation and avoid the sequelae of immobilization. Weekly assessment for the first 4 weeks is mandatory to monitor length and angulation. The adolescent male with a midshaft fracture was most difficult to manage, and in this situation, closed intramedullary nailing is recommended.

Adolescent↗
PubMed1984

Early casting of femoral shaft fractures in children.

Twenty-six children with fractures of the femur were entered into a prospective study to determine the efficacy of treating certain of these fractures by early spica cast immobilization. They were compared with 50 consecutive patients with similar fractures who were treated prior to the study to determine the potential cost savings and decrease in patient days in hospital. The clinical results of treatment were compared with results from the literature and the previous group where applicable. Our conclusion from this study is that most femoral shaft fractures in children under 10 years of age can be treated by closed reduction and early spica cast immobilization with results that are at least as good as those achieved by conventional methods, and with a 70% savings in hospital cost. Factors such as obesity, swelling, shortening, comminution, and fracture type can all combine to give relative contraindications for the use of this technique.

Casts, Surgical↗
PubMedDate not supplied

Measurement of plantar flexor spasticity during treatment with tone-reducing casts.

The purpose of this study was to examine the hypothesis that treatment with short-leg, tone-reducing casts will alter resistance of the plantar flexors to dynamic and static stretch. The torque resisting passive dorsiflexion was measured at angular velocities of 0, 12, 60, and 120 degrees/s for 16 spastic extremities. The short-term changes in dynamic sensitivity and static sensitivity were not significant. Longer-term wearing resulted in significant decreases in both dynamic sensitivity and static sensitivity. Thus, a change in resistance to stretch did occur with longer-term casting.

Casts, Surgical↗
PubMedDate not supplied

Upper extremity restraint during hip spica cast application.

Control of the upper extremities of a sedated or anesthetized patient can be a cumbersome and difficult problem during hip spica cast application. To overcome this, we developed a simple technique to control the upper extremities without placing the neurovascular structures under tension while allowing easy venous access for the anesthesia personnel. Use of a simple armboard made of supplies commonly available in the cast room has made this possible. The construction and clinical use of this armboard is described. It has been used successfully for > 12 months at the authors' institution with no untoward effects.

Anesthesia, General↗