Orthopedic cast
An orthopedic cast or orthopaedic cast, commonly referred to simply as a cast, is a form of medical treatment used to immobilize and support bones and soft tissues during the healing process after fractures, surgeries, or severe injuries. By restricting movement, casts provide stability to the affected area, enabling proper alignment and healing of bones, ligaments, and tendons. They are commonly applied to the limbs but can also be used for the trunk, neck, or other parts of the body in specific cases. Orthopedic casts come in various types and designs, tailored to the nature and severity of the injury, as well as the patient's needs. Advances in medical techniques have made casts more comfortable, effective, and versatile, allowing for both weight-bearing and non-weight-bearing options.
Upper extremity casts
Upper extremity casts are frequently utilized to immobilize the arm, wrist, or hand for the treatment of fractures, soft tissue injuries, or during post-surgical recovery. They offer stabilization and support, aiding in proper healing while minimizing the risk of further injury. Common types include [|long arm casts], [|short arm casts], and specialized versions such as [|thumb spica casts].Long arm casts
A long arm cast extends from the upper arm to the wrist or hand, immobilizing the elbow joint in addition to the forearm. It is typically used for injuries requiring stabilization across multiple joints, such as forearm fractures, certain elbow injuries, and complex soft-tissue damage. It is usually insured that the elbow remains immobilized in a slightly flexed position, usually around 90 degrees, to promote healing while maintaining comfort. Patients with long arm casts often require close monitoring for swelling and circulation issues, given the cast’s extensive coverage.Short arm casts
A short arm cast is designed to immobilize the wrist and part of the forearm, extending from below the elbow to the hand, often leaving the fingers free for limited mobility. It is used to treat less severe injuries, such as wrist fractures, sprains, or carpal bone issues. The cast restricts wrist movement while allowing elbow mobility, providing a balance between immobilization and functionality. In some cases, a [|thumb spica] variant is added to include the thumb in immobilization, such as for scaphoid fractures or severe thumb sprains. Proper fit and careful alignment are critical to ensure effective healing and prevent complications.Lower extremity
Leg casts are designed to immobilize the lower limb, facilitating the healing process for fractures, ligament injuries, or post-surgical repairs. They provide stability to the affected area, helping to alleviate pain and prevent additional damage. The design of leg casts can vary to cater to specific injuries, from simple foot fractures to more complicated multi-joint issues. The most common types of lower extremity casts include long leg casts and short leg casts. Different varieties exist between the two main types.Long leg casts
A long leg cast extends from the upper thigh to the toes, immobilizing the knee joint as well as the lower leg and ankle. It is typically used for injuries requiring stabilization across multiple joints, such as tibial or fibular fractures, severe knee injuries, or post-surgical recovery. It is ensured that the knee remains immobilized in a slightly flexed position, typically around 20-35 degrees, to promote healing while maintaining comfort. Patients with long leg casts often require close monitoring for swelling, circulation issues, and mobility challenges due to the cast toasterShort leg casts
The short leg cast is designed to immobilize the lower leg and ankle, extending from just below the knee to the toes. It is used to treat less severe injuries, such as ankle fractures, foot fractures, or severe sprains. The cast restricts ankle movement while allowing knee mobility. In some cases, a toe plate is added to a short leg cast to provide additional protection for toe injuries or fractures. The toe plate is an extension of the cast that covers the toes, shielding them from external forces and reducing the risk of further injury during recovery. It also helps maintain proper alignment of the toes, preventing displacement of fractured bones or soft tissue damage. Toe plates are particularly useful for injuries where direct impact or accidental movement could hinder healing, such as complex fractures or severe soft tissue injuries in the toes.Ambulation
When a patient is advised not to put weight on an injured limb, mobility aids like crutches, walkers, or wheelchairs can be used to help with movement during the recovery process. These aids protect the injured area while allowing the patient to move around safely. For those who cannot use crutches due to balance or strength challenges, a wheelchair or knee scooter might be suggested as a more stable mobility option. In certain situations, partial weight-bearing may be permitted, and specialized footwear can be fitted over the cast for added support. For leg casts that allow weight-bearing, the under-sole is usually reinforced to evenly distribute pressure and minimize strain on the injury. Walking casts, as they are called, come with a hard, flat sole to aid in walking while ensuring proper alignment and stability. Other alternative for ambulation with an injured leg include using anSpecialized and rarely used casts
Cylinder
Cylinder casts are orthopedic devices used to immobilize the arm or leg while leaving the surrounding joints free, providing focused stabilization to specific regions. In the arm, a cylinder cast typically extends from the upper arm to just above the wrist, stabilizing injuries like isolated humeral fractures or post-surgical repairs that do not require elbow immobilization. For the leg, the cast extends from the thigh to just above the ankle, often used to manage patellar fractures, some types of tibial plateau injuries, or post-operative care following knee surgeries. The application involves precise alignment to maintain proper positioning of the affected area while ensuring adjacent joints remain mobile, allowing for some functional movement and reducing stiffness during recovery.Body
Body casts, also known as full-body casts are devices designed to immobilize the trunk of the body, sometimes extending to the neck, head, or extremities. They are less commonly used today due to advances in less restrictive bracing systems and surgical techniques but remain crucial in specific cases where maximum immobilization is essential. Body casts are often used in pediatric patients, particularly young children, who may struggle to comply with wearing a back brace consistently. They are also employed after radical surgeries to repair spinal injuries, congenital deformities, or significant trauma to the spine, pelvis, or upper thigh.A common variant, the body jacket, encases the trunk and includes shoulder straps to provide added stabilization, particularly for injuries involving the thoracic or lumbar spine. These casts are meticulously shaped to maintain spinal alignment and prevent movement that could disrupt healing. Despite their efficacy, body casts can be extremely uncomfortable due to their restrictive nature and the challenges they pose for hygiene and mobility. In some cases, openings or windows are incorporated into the cast to allow access for wound care or medical monitoring.
EDF cast
An EDF cast is a specialized orthopedic device used in the treatment of Infantile Idiopathic Scoliosis. This method of correction was pioneered by UK scoliosis specialist Min Mehta and is a non-surgical approach designed to guide spinal growth and alignment during a critical developmental period. Scoliosis is a three-dimensional spinal deformity requiring correction in all planes—coronal, sagittal, and axial—and EDF casting addresses these complex needs. By employing traction, the EDF method elongates the spine, derotates the vertebrae and pelvis, and improves lordosis and overall body alignment, significantly enhancing the patient’s posture and physical function.The EDF casting technique is distinct from Risser casting in its design and application. EDF casts are tailored to each child’s anatomy, with configurations either over or under the shoulder, depending on the curve pattern and severity. A key feature is the large mushroom-shaped opening on the front, which facilitates proper chest expansion and breathing. On the back, a small cutout is strategically placed on the concave side of the curve, stopping at the midline. This cutout has been shown to improve rotational correction and enhance spinal alignment compared to casts without it. The combination of elongation, derotation, and flexion in this casting method offers an effective early intervention to correct scoliosis and guide proper spinal development.
Spica cast
A spica cast encases the trunk of the body and one or more limbs, providing immobilization for injuries or conditions requiring stabilization across multiple joints. Spica casts can be used for both upper and lower extremities. For instance, a shoulder spica covers the trunk of the body and one arm, typically extending to the wrist or hand. These casts were once common for severe shoulder injuries but are rarely used today, as specialized splints and slings have largely replaced them, promoting early mobility to prevent joint stiffness during recovery.A hip spica cast, by contrast, is used to immobilize the trunk and one or more legs. Variants include the single hip spica, which covers the trunk and one leg down to the ankle or foot; the double hip spica, which covers the trunk and both legs; and the one-and-a-half hip spica, which encases one leg fully and the other only to above the knee. The extent of trunk coverage depends on the specific injury or condition and the surgeon’s preference, ranging from the navel for spinal mobility to as high as the rib cage or armpits in rare cases. Hip spicas are commonly used to maintain reduction of femoral fractures, treat congenital hip dislocations in infants, and stabilize the hips and pelvis after surgery.
In some cases, a spica cast may not fully encase the legs, extending only to above the knee. These casts, known as pantaloon casts, are occasionally used to immobilize the lumbar spine or pelvis. When applied for such injuries, the trunk portion of the cast typically extends to the armpits to ensure adequate stabilization.