Orthopedic Casting Techniques

Instructor: Kaitlin Baker

Kaitlin has taught nursing students and has a master's degree in nursing leaderhsip, as well as a bachelor's degree in English literature.

In this lesson, you will learn about the different methods used to heal broken bones. From the time of the ancient Egyptians, to modern casting, to 3-D printing, medicine has used increasingly innovative and creative techniques to help bones heal faster and more comfortably.

Treating Broken Bones Through the Ages:

Imagine breaking your leg while auditioning for a major athletic competition. You limp to the doctor, who says she can fix your leg in no time! She wraps a piece of tree bark in cloth and ties it to your leg. You'll be healed up before you know it! she says.

This may sound crazy to us today, but this is how the ancient Egyptians treated fractures in 3000 BC.

A fracture is the medical term for a break in a bone or cartilage, usually because of a traumatic injury. For example, you can suffer a fracture as you are leaping off the rope swing and you land awkwardly on one leg, rolling your ankle and hearing the bone snap.

There are several kinds of fractures, and there are also several ways that orthopedists , or the medical doctors who deal with bones and their supporting structures, use to repair them. Most of these methods are accomplished with use of a cast. A cast is a set of materials used to keep your broken bone immobilized- or unable to move out of the correct position while it heals. Casts provide immobilization both above and below the injured area, which is why someone with a wrist fracture, for example, may have a cast that extends down to the hand and up to the forearm.

Plaster Cast:

A plaster cast is made from strips of gauze and plaster that have been soaked in water. Before using these strips, the doctor or cast technician who has been specially trained to apply casts wraps the limb with a cloth sleeve to protect the skin. Then, the strips that have been soaked are wrapped around the limb. The materials dry and harden, forming the cast. However, you have to be careful with walking and other physical activities afterward, since the cast doesn't completely dry for two to three days. Even after that, you are not allowed to swim or bathe without the cast covered.

An example of a Plaster Cast

Synthetic Cast:

A synthetic cast is made from fiberglass or plastic. These materials are wrapped around your leg in the same way as a plaster cast, except synthetic casts are lighter in weight. It only takes a few minutes for synthetic casts to dry and only a few hours for them to harden. This is the type of cast we typically think of having our friends sign. You can choose from several colors for a synthetic cast, and you can even wear some of them when swimming or taking a shower!

An example of a Synthetic Cast

Cast Brace:

A cast brace is made from hard plastic. Sounds uncomfortable, right? Don't worry, your leg will be protected from the hard material by soft pads which compress or push up against the place where your leg is broken. This not only makes it more comfortable, but also helps keep your broken bone in place while it heals. The upside to cast braces is that you don't need to worry about waiting to walk around or put weight on them. They can be used right away. This type of cast is also used after one of the other types of casts is removed, toward the end of the healing process.

An example of a Cast Brace

Splint:

A splint, otherwise known as a half cast is made from large pieces of fiberglass that hold your injured leg in place. A bandage is then wrapped around the leg to keep the materials in place. Sounds similar to the ancient Egyptians, doesn't it? This type of cast may be used if you have a lot of swelling and the orthopedist wants to wait for it to go down before fitting you for a more long-term cast.

An example of a Splint

Casts Across History:

These are some of the options that an orthopedist might consider when treating your broken leg. You certainly have more options than the ancient Egyptians…or the early Romans who, in 30 A.D., had their fractures treated with corn-stuffed splints, or bandages stiffened with wax. Medieval treatment consisted at times of primitive casts made of egg whites, flour, and animal fat. Sounds more like making a cake than treating an injury. Perhaps you would get a snack while waiting for your leg to dry!

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