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Casting of lower limb for pediatric fractures

1. General introduction to nonoperative fracture care

Klaus Dresing and Jos Engelen are presenting a live interactive Webcast.

Learning goals

  • Describe the characteristics of the different casting materials.
  • Explain the principles of cast application.
  • Define the basic steps of post application treatment.
  • Recognize potential for and prevent complications.
  • Apply casts and splints and prescribe orthoses.

2. Videos from "Casts, Splints, and Support Bandages—Nonoperative Treatment and Perioperative Protection"

Introduction

The below videos are taken from the AO Publication "Casts, Splints, and Support Bandages - Nonoperative treatment and perioperative protection" edited by Klaus Dresing, Peter Trafton, and Jos Engelen. This publication examines the principles, methods, and techniques for applying a modern plaster or synthetic cast for the treatment of fractures, ligament, nerve, and soft-tissue injuries, overload injuries, and infections. It includes access to 55 cast and splint demonstrations on high-quality online video.

The book can be purchased both as a hard copy and as a E-Book

Casting book

Cylinder long leg cast

Synthetic, combicast technique

Indications

  • Fracture of the distal femur
  • Fracture of the proximal tibia
  • Fracture of the patella
  • Ligamentous rupture of the knee

Goal

  • Stabilization of the knee joint

Dorsal long leg splint

Plaster of Paris

Indications

  • Fracture of the tibia
  • Fractures around the knee

Goal

  • Stabilization of the knee and lower leg

Dorsal short leg splint

Plaster of Paris

Indications

  • Fracture of the ankle
  • Fracture of the tarsal bones
  • Ligamentous ruptures

Goal

  • Stabilization of the ankle joint and foot
Synthetic

Indications

  • Fracture of the ankle
  • Fracture of the tarsal bones
  • Ligamentous ruptures

Goal

  • Stabilization of the ankle joint and foot

Fifth metatarsal cast

Synthetic, combicast technique

Indications

  • Fracture of the proximal fifth metatarsal
  • Fracture of the ankle, type Weber A
  • Avulsion fracture of the medial malleolus

Goal

  • Stabilization of the ankle joint and the tarsus

First toe orthosis

Synthetic, combicast technique

Indications

  • Fracture of the first toe
  • Perioperative protection after hallux valgus surgery

Goal

  • Stabilization of the first toe and first ray

Foot cast

Synthetic, combicast technique

Indications

  • Fracture of the metatarsals
  • Fracture of tarsals
  • Postoperative treatment after osteosynthesis of tarsals and metatarsals

Goal

  • Stabilization of hindfoot, midfoot and forefoot

Hinged knee brace

Indications

  • Fracture of the diaphyseal and distal femur
  • Fracture of the proximal tibia
  • Knee dislocations and ligamentous lesions
  • As an alternative to a prefabricated orthosis
  • This hinged brace is not for primary care

Goal

  • Stabilization of the knee allowing limited motion of knee joint
  • Functional treatment of the knee

Long leg cast

Plaster of Paris

Indications

  • Fracture of the distal femur
  • Fracture of the proximal tibia
  • Fracture of the tibial shaft

Goal

  • Stabilization of the distal upper leg and the lower leg
Synthetic, combicast technique

Indications

  • Fracture of the distal femur
  • Fracture of the proximal tibia
  • Fracture of the tibial shaft

Goal

  • Stabilization of the distal upper leg and the lower leg

One-and-a-half leg hip spica cast

Plaster of Paris

Indications

  • Pediatric fracture of the femur

Goal

  • Stabilization of the leg and hip

Sarmiento (patella tendon bearing) cast

Plaster of Paris

Indications

  • Stable diaphyseal fractures of the tibia limited to the distal two-thirds of the tibial shaft
  • Primary unstable tibial fractures at the hard callus formation stage

Goal

  • Stabilization of the lower leg

Sarmiento tibial brace

Synthetic, combicast technique

Indications

  • Some diaphyseal fractures of the tibia
  • Not recommended for primary fracture care

Goal

  • Stabilization of the tibia

Short leg cast

Rigid synthetic

Indications

Secondary treatment of:

  • Fracture of the distal tibia
  • Fracture of the ankle
  • Fracture of the foot

Goal

  • Stabilization of the distal tibia, the ankle, and the foot
Synthetic, combicast technique

Indications

Secondary treatment of:

  • Fracture of the distal tibia
  • Fracture of the ankle
  • Fracture of the foot

Goal

  • Stabilization of the distal tibia, the ankle, and the foot

Single leg hip spica cast

Synthetic, combicast technique

Indications

  • Pediatric fracture of the femur

Goal

  • Stabilization of the leg and hip

3. Webinar

Casting in Children - Indications and Techniques

Theddy Slongo is presenting an interactive webinar about casting in children discussing indications and techniques.

Learning objectives:

  • Identify those fractures which are suitable for conservative treatment.
  • Explain the main biomechanical principles of cast fixation.
  • Recognize the difference between conventional plaster of Paris and fiber casting tape.
  • Describe the steps of correct casting techniques for the most frequent indications.
  • Anticipate the major risks and complications of casting.
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