Plaster Of Paris Cast Research Articles

Comparative Evaluation of the Efficacy of Shallakyadi Plaster and Standard POP in the Management of Simple Fractures of Long Bones of the Upper Limb: A Research Protocol

Introduction: Fracture management is one of the wellestablished concepts in Ayurveda with numerous fracture healing drugs mentioned for topical application. The present study is an attempt to form a compound of few of those drugs which can be used as a plaster cast. The effect of this Herbomineral ayurvedic plaster cast on fractures would be studied both in aspects of immobilisation and fracture healing. Shallakyadi plaster which is a novel compound composed of resin of Boswellia serrata Roxb, resin of Acacia nilotica (Linn.) Willd.ex Del, root of Glycirrhiza glabra Linn, whole plant of Cissus quadrangularis Linn, Stem of Rubia cordifolia Linn, bark of Terminalia arjuna Wight & Arn (W&A), resin of Commiphorawightii Arn, Kaolinite (phyllosilicate of aluminium) and hydrated magnesium silicate can be used as a herbomineral ayurvedic compound for the healing of fractures. Need of Study: Standard Plaster of Paris (POP) cast has no therapeutic role on healing of fracture other than the purpose of immobilisation, whereas the drugs in Shallakyadi Plaster have known effects on bone healing and also provide the adequate immobilisation provided by Standard POP cast. Hence, the present study will compare the efficacy of Shallakyadi Plaster and Standard POP in the management of simple fractures of long bones of upper limb. Aim: To study and compare the efficacy of Shallakyadi plaster and standard POP in the management of simple fractures of long bones of upper limb. Materials and Methods: The present study is designed as a randomised control trial which would be conducted in Mahatma Gandhi Ayurveda College Hospital and Research Centre (MGACHRC), Salod Hirapur (H), Maharashtra, India for three months, in which 60 patients will be enrolled. Standard POP Plaster or Shallakyadi plaster will be applied for local application over the fractured area. Parameters like pain, swelling, loss of function, tenderness would be studied subjectively and callus formation would be taken as the objective parameter. Statistical analysis would be done using GraphPad Prism 7.0 V software and statistical tests- Chi-square test, Wilcoxon’s rank sum test and Wilcoxon’s signed rank test will be applied with level of significance as 0.05.

Robert Jones bandage versus cast in the treatment of distal radius fracture in children: A randomized controlled trial

PurposeThe present study aimed to treat fractures of the distal end of the radius in children with Robert Jones (RJ) bandage. The objective was to compare this treatment modality with the cast regarding the frequency of the complication occurrence, child comfortability, and family satisfaction. MethodsThe study was a randomized controlled non-inferiority clinical trial including children with recent (less than 5 days) fractures at the distal end of the radius OTA/AO 23-A2, which is usually treated conservatively. Those with open fractures, pathological fracture, severely displaced fracture that needs reduction or multiple injuries were excluded. The participants were divided randomly into 2 groups according to the treatment modalities. Group 1 was treated by plaster of Paris cast (the control group), and Group 2 by modified RJ bandage (the trial group). The difference between the 2 groups was found by the Chi-squared test. The difference was considered statistically significant when the p value was less than 0.05. ResultsThere were 150 children (aged 2 – 12 years, any gender) included in the study, 75 in each group. The complications occured in 5 (3.3%) cases only, pressure sores of 3 cases in Group 1 and fracture displacement of 2 cases in Group 2. There was no statistically significant difference in the rate of complication occurrence between both modalities of treatment (p = 0.649). Children treated by RJ bandages were more comfortable than those treated by the cast (97.3% vs. 73.3%, p < 0.001) with a statistically significant difference between them. Contrary to that, the families were more satisfied with the cast than RJ bandage (88.0% vs. 81.3%), but without a statistically significant difference (p = 0.257). ConclusionRJ bandage is a non-inferior alternative to the cast for the treatment of fractures at the distal end of the radius that can be treated conservatively in children.

Comparison of Antegrade Percutaneous Intramedullary K-wire Fixation and Transverse Pinning for Treatment of Unstable Displaced Metacarpal Neck and Shaft Fractures: A Prospective Interventional Study

Introduction: Metacarpal fractures account for upto 10% of all body fractures and 36% of all hand fractures in adolescents, young adults, and active adults. Fractures of the metacarpal shaft and neck are common in all metacarpal fractures after direct trauma, roadside accidents, or sports injuries. The ratio of the shaft to the neck is 1:2. Closed reduction and plaster of paris cast can be used to treat the majority of these fractures conservatively. Unstable and comminuted fractures necessitate surgery. Aim: To compare the clinical, functional and radiological outcomes in antegrade intramedullary fixation and transverse pinning of metacarpal fractures in patients of unstable and displaced metacarpal shaft and neck fractures. Materials and Methods: A single-institutional prospective interventional study identified 60 cases of metacarpal fractures between November 2019 to August 2021. Each of the cases met the inclusion criteria for closed extra-articular fractures, displaced and unstable fractures of the metacarpal bone. The patients were divided into two groups having 30 subjects each, randomly allotted to two groups (Antegrade intramedullary K-wiring and Transverse Pinning). Outcomes were compared for range of movement by the American Society of Hand Surgeons Total Active Motion score (ASSH TAM), Visual Analog Scale (VAS), and radiological parameters (Angulation). Patients were followed-up for 12 weeks. Complications were listed in terms of pin site infection. Results: Most of the patients were found to be in the third decade of life. The fracture union was achieved at 8±2 weeks. Clinical evaluation done by VAS score which was found to be statistically insignificant between two groups (p-value=0.243). Radiological assessment evaluated by measuring postoperative angulation between two groups was found to be statistically insignificant (p-value=0.248). Difference in functional evaluation between the two groups done by ASSH TAM was found to statistically significant between the groups (p-value=0.036). Conclusion: Both antegrade intramedullary K-wiring and transverse pinning demonstrate good and comparable results for extra-articular neck and shaft metacarpal fractures. However, the former is superior in terms of final range of motion as per ASSH TAM score.

Plaster of Paris: Squeeze, But Not Too Hard!

Plaster of Paris (PoP) has been the predominant treatment option for most acute and chronic orthopedic conditions. Water immersion significantly decreases the PoP bandage strength. Moreover, concerns have been raised about the possibility of breaks in PoP splints and cast failures once solid. The current study was designed to account for the increase in weight associated with increased PoP layers. The authors hypothesized that by controlling for weight variation as layers increased, they could determine the number of layers of PoP bandage that truly results in optimal mechanical properties. They assessed whether adequate plaster weight control while increasing layers could improve the mechanical properties of the splint. [Orthopedics. 2022;45(1):e57-e61.].

Radiological and Functional Outcome of Distal Radius Fracture treated conservatively vs Percutaneous K-wire fixation

Aim: To compare the radiological and functional result of conservatively treated distant radius fractures (manipulation under anesthesia and plaster of paris) versus percutaneous K- wire fixation Study design: Retrospective Duration and place of study: Department of Orthopedic Surgery, The Indus Hospital, Raiwind campus Lahore from July 2018 to August 2020. Methods: The sample size of 100 patients aged between 18-60 years, closed, isolated distal radius fracture were included, and patients with diabetes mellitus, ischemic heart disease, pathological fractures, chronic renal disease, head injury, chronic liver disease, whose Glasgow coma scale was &lt;14, malignancy were excluded. Patients were randomized as A &amp; B by lottery method. They managed with conservative treatment ( manipulation under anesthesia (MUA) and plaster of paris (POP) cast) and K- wire fixation in groups A &amp; B, respectively. Side of the fractured bone, infection, radiological union, and function outcome were recorded. Results: Amongst the total 100 patients in group-A, 32(63.8%) were males, and 18(36.2%) were females, and 35 (70.2%) were males, and 15 (29.8%) were females in Group-B. in group A patients mean age was 38.86.19 years, while patients mean age of the group B was 39.57.36 years. With the conservative method, 45(95.7%), the union rate was while with the K- wire fixation method, the union rate was 48(96%). In group-A, 35(70%) had excellent, 10 (20%) good, 03 (6%) had an average, and 2(4%) poor and in group-B, 40(80%) had excellent, 04 (08%) good, 04(08%) had an average, and 02 (4%) poor functional outcome. Conclusion: In terms of clinical and radiological evaluation, fixation of a distal radius fracture with K-wires has a better outcome than conservative treatment (MUA and POP cast) with a low infection rate and better union and result. Keywords: closed fracture, distal radius, back slab, K-wires

English

BACKGROUND Closed reduction with plaster of Paris (POP) cast for extra-articular distal radius fractures was an accepted method of treatment worldwide. But the maintenance of reduced fracture fragments was unpredictable. Closed reduction and ‘K’ wire fixation with casting was also recommended widely. There was no definite option prescribed for either of the methods. In this study, we wanted to compare the final outcome of management of the distal radius fractures in adults with closed reduction and POP casing versus closed reduction with percutaneous K-wiring. METHODS A prospective, randomized, and comparative study was conducted on the final outcome of two methods of treatment for the fractures of distal end of radius. One method (Group A of 23 patients) consisted of closed reduction and POP casing and the other (Group B of 23 patients) consisted of K-wiring under C arm (23 patients in each group). Radiological and functional parameters were compared at fixed intervals for 15 months and final outcome scores were correlated and compared using Gartland and Werley functional scoring system. RESULTS In group A, AO type 2R3A2.1 fractures were observed in 03/23 (13.04 %) patients and 04/23 (17.39 %) in Group B patients. Type 2R3A2. 2 fractures were observed in 05/23 (21.73%) of the group A patients and 07/23 of the group B patients. Type 2R3A2.3 fractures were observed in 15/23 of the group A and 12/23 (52.17%) of the group B patients. Both the methods of treatment were correlating well with the various variables. CONCLUSIONS Closed reduction with percutaneous K wiring and below elbow cast application was a simple, minimally invasive technique that provided added stability and functional outcome with respect to treatment of extra-articular distal radius fracture. The conventional method of closed reduction and POP cast was closely correlating with the K wire immobilization method. There was no significant statistical difference between the two methods in the functional outcome after treatment of distal end radius fractures. KEYWORDS Radius, ‘K’ Wire, Closed Reduction, Stable Fracture, Bone Healing and Immobilize

Open diaphyseal fracture of the tibia in Pakistani adults: A comparative study of Plaster of Paris cast vs. Naseer Awais external fixator.

Background: The management of open tibial diaphyseal fractures is the most challenging glitch faced by orthopedic surgeons. For open or comminuted fractures, external fixation remains the gold standard. This study aimed to assess the treatment response of fixators by comparing the results of open diaphyseal tibial fracture stabilization in adults by Plaster of Paris (POP) cast versus Naseer Awais External Fixator (NAEF).&#x0D; Methodology: A single-center, prospective study was conducted at the leading teaching institute and tertiary care hospital of Jamshoro and Hyderabad, Pakistan. A total of 30 patients having an open diaphyseal fracture of the tibia were randomly assigned to two groups (Group A-POP cast and Group B to NAEF; n=15 each). Duration of hospital stay and postoperative complications (like wound infection, union rate, and functional outcome) were compared between groups.&#x0D; Results: On average, group A patients stayed in the hospital for 3.65 weeks, while group B patients stayed for 2.49 weeks (p=0.004). Wound infections were observed in 26.7% and 53.3% of the patients in group A and B, respectively. No significant difference in the adequate callus formation (i.e. union) and good functional outcome was observed among patients of group A and B (p&gt;0.05). &#x0D; Conclusion: The use of NAEF for open diaphyseal fractures of the tibia has a significant advantage over POP cast in reducing the duration of hospital stay. However, no significant differences were observed in wound infection, union rate and time, and functional outcome.

Treatment of a Chronic, Nonhealing Neuropathic Ulcer in a Pediatric Patient With Spinal Dysraphism: A Case Report

The purpose of this case study was to describe the management of a chronic, nonhealing neuropathic ulcer on the dorsum of the left foot of an 11-year-old boy with spinal dysraphism. Autologous platelet-rich plasma (PRP), obtained using a double centri-fuge technique, was applied weekly underneath a nonadherent dressing and a below-knee plaster of paris cast. Complete non-weight-bearing was encouraged. The patient presented with a 9 cm2 wound and a Pressure Ulcer Scale for Healing (PUSH 3.0) score of 13, which was of 6 months' duration. For the first 3 weeks, the autologous PRP and plaster cast were applied weekly. After 3 weeks, the wound was 2.25 cm2 (PUSH score 7) and treatment was changed to moistened saline dress-ings underneath the cast. The wound was healed after 5 weeks. No adverse effects were observed. Studies are needed to evaluate the safety and effectiveness of autologous PRP in neuropathic ulcer management in pediatric populations and to obtain evidence for optimal management of these wounds in persons with spinal dysraphism.

ROLE OF PLASTER OF PARIS CAST IMMOBILIZATION OF SKELETAL PIN FOLLOWING SKELETAL TRACTION ABSTRACT

BACKGROUND: Application of skeletal traction, requires insertion of skeletal pin which inflicts an open skin wound around the pin, impending portal for entry of microbes into the pin tract. Associated notable complications are metal reactions and secondary infection, subsequently leads to pin change or removal, failure of fracture union, septic arthritis, osteomyelitis etc. Aim of the present study was to compare the pin tract infection grade of elderly patients having open pins with antiseptic dressing and cases immobilized with plaster of Paris (POP) cast.&#x0D; MATERIALS AND METHODS: The study population consists of 88 patients treated with upper tibial skeletal traction, of whom 44 persons followed up by regular antiseptic dressing of open percutaneous pin would (Group 1) and the rest 44 persons having pin covered with POP cast (Group 2). Pin tracts of both groups were evaluated after 6 weeks by Checketts-Otterburn’s grading system. Primary outcome variables of infection gradation and outcome measures was compared by NNT with 95% confidence interval, proportion and percentage.&#x0D; RESULTS: Mean age of patients of group 1 was 69.75, SD 7.185 and group 2 was 68.95, SD 8.177. Skeletal pin had to be removed (Grade 4 in Checketts-Otterburn’s grading system) in 10 (66.7%) of group 1 compared to only 5 (33.3%) cases of group 2. No case of osteomyelitis (Grade 6) has been seen in any group. The difference in grade of pin tract infection in the two groups was statistically significant (p =0.001).&#x0D; DISCUSSION&#x0D; High morbidity in conservative treatment is vastly the result of continuous pain, infection and discomfort. The present study compellingly documented non-operative management by skeletal traction is far from being the lethal procedure if the the rate of pin tract infection is reduced by covering with POP cast. In institutes that cater to a significant number of elderly population, skeletal traction with appropriate control of pin site infection is an effective alternative to more aggressive operative method.&#x0D; Keywords: Skeletal Traction, Pin Tract Infection, Elderly Patients, Plaster of Paris (Pop) Cast.

Prevalence of Symptomatic Venous Thrombo-Embolism in Patients with Total Contact Cast for Diabetic foot Complications; A Retrospective Case Series

Category: Ankle, Diabetes, Midfoot/Forefoot Introduction/Purpose: Venous thrombo-embolism (VTE) is a costly and potentially life threatening complication of limb immobilisation in a plaster of Paris cast. It is now generally recommended that patients undergoing limb immobilisation in cast are given LMWH therapy. The gold standard of treatment for diabetic patients with Charcot feet is total contact casting (TCC). TCC is also employed in the management of diabetic foot ulceration (DFI). Such casting is often prolonged with a time frame greater than 6 weeks. In general diabetic patients with established complication, (Charcot, DFI) often have comorbidities which increase the risk of VTE when the limb is immobilised. One would anticipate these patients to have a high rate of VTE given the immobile limb and comorbidities contributing to higher risk. Methods: A retrospective review was undertaken. A search on patients’ records up to April 2015 was undertaken to identify patients placed into total contact casting. These patients all had DFI or Charcot treated with a TCC. The patient’s electronic and paper records were reviewed for any documentation of VTE, as well as other co-morbidities. Results: 18 patients aged between 43 and 78 (mean 60) were identified. These patients were casted between one week to 3 months. None of these 18 patients sustained a documented VTE. None of them were on prophylactic anti-coagulation for the time they were in cast. All of the patients had a documented significant cardiovascular history (as well as Diabetes Mellitus), with HbA1c values ranging from 45 to 122 (median 74). Body mass index values for all of the patients were unavailable. Conclusion: Despite high risk for the developing a VTE, none of the patients in our series suffered a documented symptomatic PE or DVT. We recognise the limitations of our study; small numbers with retrospective review. Nonetheless, we hypothesised that with prolonged contact casting in patients with significant comorbidity the prevalence of VTE would be higher than that observed. We believe that this is the first study looking for VTE in a TCC and diabetic population.

Comparison of the moulding ability of Plaster of Paris and polyester cast material in the healthy adult forearm

ObjectivesTo quantify the moulding ability of Plaster of Paris and polyester cast materials as assessed by the novel use of peripheral quantitative computed tomography. MethodsA prospective crossover study was performed in 25 healthy volunteers aged 18–65 years. Participants’ non-dominant wrist was immobilized using a synthetic polyester cast followed by a Plaster of Paris cast with three point moulding to simulate reduction of a dorsally angulated distal radius fracture. The novel use of peripheral quantitative computed tomography was used to measure the closeness of fit of each cast on an axial tomographic slice. Results and conclusionsPlaster of Paris casts were able to achieve a closer mould than polyester when measured between the bone and the cast (p=0.002), as well as between the skin and the cast (p=0.001). There was no difference when stratified on BMI. Using pQCT assessment, a closely moulded fit was able to be more consistently achieved when using Plaster of Paris when compared to polyester casts of the distal radius. Level of evidenceIII.

Lower limb intracast pressures generated by different types of immobilisation casts.

AIMTo determine if complete, split casts and backslabs [plaster of Paris (POP) and fiberglass] generate different intracast pressures and pain.METHODSIncreased swelling within casts was modeled by a closed water system attached to an expandable bag placed directly under different types of casts applied to a healthy lower limb. Complete fiberglass and POP casts, split casts and backslabs were applied. Twenty-five milliliter aliquots of saline were injected into the system and the generated intracast pressures were measured using a sphygmomanometer. The subject was blinded to the pressure scores to avoid bias. All casts were applied to the same right limb on the same subject to avoid the effects of variations in anatomy or physiology on intracast pressures. Pain levels were evaluated using the Visual Analogue Score after each sequential saline injection. Each type of cast was reapplied four times and the measurements were repeated on four separate occasions. Sample sizes were determined by a pre-study 90% power calculation to detect a 20% difference in intracast pressures between cast groups.RESULTSA significant difference between the various types of casts was noted when the saline volume was greater than 100 mL (P = 0.009). The greatest intracast pressure was generated by complete fiberglass casts, which were significantly higher than complete POP casts or backslabs (P = 0.018 and P = 0.008 respectively) at intracast saline volumes of 100 mL and higher. Backslabs produced a significantly lower intracast pressure compared to complete POP only once the saline volume within casts exceeded 225 mL (P = 0.009). Intracast pressures were significantly lower in split casts (P = 0.003). Split POP and fiberglass casts produced the lowest intracast pressures, even compared to backslabs (P = 0.009). Complete fiberglass casts generated the highest pain levels at manometer pressures of 75 mmHg and greater (P = 0.001). Split fiberglass casts had significantly reduced pain levels (P = 0.001). In contrast, a split complete POP cast did not produce significantly reduced pain levels at pressures between 25-150 mmHg. There was no difference in pain generated by complete POP and backslabs at manometer pressures of 200 mmHg and lower.CONCLUSIONFibreglass casts generate significantly higher intracast pressures and pain than POP casts. Split casts cause lower intracast pressures regardless of material, than complete casts and backslabs.

Effect of Polyester and Plaster of Paris Casts on Determination of Volumetric Bone Mineral Density Assessed by Peripheral Quantitative Computed Tomography (pQCT).

Peripheral quantitative computed tomography (pQCT) is a non-invasive, low-radiation tool for measuring volumetric bone mineral density. It has potential for use in fracture healing applications; however, the unknown attenuation effects of cast material on peripheral quantitative computed tomography have contributed to its limited use in this area. The effect of two common cast materials, polyester and Plaster of Paris was investigated by performing both in vitro and in vivo studies. The in vitro study tested the effect of increasing layers of cast material on bone density measurements performed on a hydroxyapatite phantom. Cast thickness was directly associated with a reduction in bone mineral density, with twelve layers of polyester and Plaster of Paris resulting in a 0.55 and 2.21% decrease in bone density measurements. Precision error in situ with polyester cast material was 0.71%, and 2.31% with Plaster of Paris cast material. The in vivo study comprised a prospective trial with 28 healthy adult participants to evaluate the effect of the two cast materials. Trabecular bone mineral density was increased by 0.5% in the presence of a polyester cast and decreased by 4.22% in the presence of a Plaster of Paris cast. Cortical bone mineral density was decreased by 3.46 and 5.54% for polyester and Plaster of Paris, respectively. This study quantified the effects of orthopaedic casts on pQCT-derived bone parameters. The results suggest applicability of commonly utilised cast materials in combination with pQCT to assess fracture healing.

Internal fixation and bone grafting for intraarticular nonunion of tibial plateau: a report of four cases

Intraarticular nonunion of tibial plateau is rare. In the literature, only 9 patients were found to be treated for intraarticular tibial plateau nonunion and they got varying results. Internal fixation along with bone grafting was done as a standard treatment in all cases. We treated 4 different profile cases of intraarticular tibial plateau nonunion in our institution by 4 different methods. We treated these cases with plaster of paris cast, internal fixation along with bone graft, arthrodesis with K-nail and total knee replacement. Case 1 was treated with plaster of paris (POP) cast as the patient refused surgery. The fracture was united and the patient was fully satisfied with full range of motion despite valgus malalignment. Case 2 was managed with open reduction internal fixation along with bone grafting. The patient had a good union and got full range of motion at the knee joint. Case 3 was treated with total knee arthroplasty due to her old age and got satisfactory result. Case 4 was an infected nonunion. Arthrodesis was done and the patient could walk with full weight bearing independently. We conclude that internal fixation along with bone grafting may not be suitable in all cases of intraarticular nonunion of tibial plateau. Causes of nonunion, present condition and range of motion of the knee joint, as well as the age of patient should be all considered and the treatment should be individualised according to each patient's situation.

An audit of over two decades of treating pituitary adenomas at a tertiary care facility

Aims: This retrospective audit of long-term outcomes and treatment sequelae with conventional radiotherapy (RT) is presented with an objective to provide baseline data with which outcomes of high precision techniques (fractionated radiosurgery and intensity-modulated RT [IMRT]) may be compared. Materials and Methods: Between the years 1990 and 2012, a total of 182 patients of pituitary adenoma were registered in the Department of Radiotherapy. Of these, 156 received RT. Immobilization consisted of a plaster of Paris cast (1990–1995), acrylic cast (1996–2000), a three-point head fixation thermoplastic cast (2001–2006), and now we are using “U”-IMRT thermoplastic cast since 2007 onward. A 2-field technique was used in 7% patients, whereas in the remaining 93% patients, 3-field technique was used. Forty-seven percent of patients were treated on a telecobalt unit and the remaining 53% patients on 6 MV linear accelerator. Rectangular fields, no field shaping, and appropriate wedges were used with mean field sizes (standard deviation [SD] and range) being 41.4 cm2 (16, 25–100). Mean dose (SD, range) was 47.5 Gy (SD 3.2; range 45–55) given in 1.8–2.0 Gy/fraction, 5 fractions/week. Results: Sixty percent of patients were (93/156) males. Median age was 37 years (mean - 37, SD - 13.2, range 12–66); 40.4% (63/156) had functional tumors. Presenting features were mainly headache 125 (80%), field defects 91 (58.3%), menstrual disturbances 33 (53% of women), and acromegalic features 38 (24.4%). Suprasellar extension, 129 (82.7%), was most common. All patients underwent resection; out of them, 28.2% patients had multiple surgeries. At a median (range) follow-up of 33 months (2–212) of all patients, the estimated freedom from progression was 96% at 2 years and 92% at 5 and 10 years with no patient failing beyond 18 months. Conclusions: Conventional external RT as described in postoperative cases of pituitary adenoma is safe and effective for tumor control with a median time to normalization of hormonal hypersecretion being about 30 months.

Distal end radius fractures: evaluation of results of various treatments and assessment of treatment choice

ObjectiveThe rapid expansion of knowledge regarding the functional anatomy of hand and wrist, increasing functional demands of senior citizens and improved methodologies of achieving and maintaining anatomic restoration of distal radius fractures has generated a renewed interest in addressing these fractures in a more precise manner. The purpose of our study was to evaluate the difference in patients function among those treated by 1) closed reduction and Plaster of Paris cast, 2) distractor application, or 3) open reduction and internal fixation with a volar plate, and to assess the treatment choice for each particular fracture type. MethodsA prospective study was carried out on 60 patients with fractures of the distal end radius. Fractures were classified according to the AO classification into type A (extra-articular), type B (partial articular) and type C (complete articular). After initial evaluation patients were taken up for either conservative or operative treatment and were followed up for two years. ResultsAnatomical results were evaluated according to the Sarmiento’s modification of Lindstrom Criteria, which showed that excellent results were more frequent with open reduction and internal fixation using the plating technique. Clinical and functional results were evaluated according to the demerit point system of Gartland and Werley with Sarmiento modification, which was revealed to relate with the type of treatment techniques. ConclusionThere is no customized solution for all the fractures of the distal radius. The choice of treatment should be based on the fracture type, the patient’s characteristics, the patient’s demands and the treating surgeon’s experience and preference.

Treatment of Clubfoot With Ponseti Method Using Semirigid Synthetic Softcast.

Randomized controlled clinical trial.The main purpose of the present study was to comparatively analyze the effectiveness, advantages, and the complications of using semirigid synthetic softcast with respect to plaster of Paris (POP) during the treatment of clubfoot deformity.The study group consisted of 196 babies (249 feet). A total of 133 feet treated by an orthopedic referral center using semirigid synthetic softcast were included in group A whereas the other 116 feet treated by another orthopedic clinic using POP cast were included in group B. The Pirani scores, number of cast applications, time period until Achilles tenotomy, any skin problems due to the cast itself, and/or cast removal were recorded. A final parent satisfaction score was also obtained.The mean Pirani sores were significantly improved from the first administration to the time before Achilles tenotomy in both groups. There was no significant difference according to the number of casts applied until tenotomy. The slippage of the cast and skin lesions was significantly more common in group B. Higher parent satisfaction levels were detected in group A.Semirigid softcast has been found as superior to POP in the aspects of parent satisfaction and cast-related complication rates.

External immobilization for fracture repair in goats

Due to the frequent occurrence of long bone fractures in goats and paucity of literature regarding their economic management, a study was conducted to establish the external immobilization of long bone fracture with Plaster of Paris (POP) versus hybrid cast and evaluate the fracture healing by clinical and radiographic studies. Plaster of Paris cast was helpful to restrict the movement in all the cases of Gr-I while external fixation by hybrid cast was helpful to restrict the movement of fracture fragments in all the cases of Gr-II. The overall observations for weight bearing in the study revealed that the animals of Gr-II showed early full weight bearing. Clinically the animals of Gr-II showed early ambulation with better fracture healing. The complications were more in POP cast as compared to hybrid cast.

Assessment of the physical and mechanical properties of plaster of Paris bandage cast used as a splinting and casting materials

Aim: To assess the physical and mechanical properties of plaster of Paris (POP) bandage cast used as a splinting and casting materials. Materials and Methods: POP casts were divided into three Groups A, B and C with 2, 3 and 8 layer for POP bandage, respectively (n=6 in each group). Handling characters, technical easiness or difficulties, setting time, weight, diameter and thickness of the casts were recorded for different groups. The casts were mounted on universal testing machine and axial load was applied @ 10 mm/min until failure. The load deflection graphs were plotted. The maximum force at which failure of the casts occurred was recorded. Stress, strain, modulus of elasticity (MOE) and stiffness of casts were calculated. Result: Construction of POP bandage cast was messy and required 45-60 min for hardening. 8 layer POP cast was comparatively heavier in weight and thicker in cross section than 3 layer cast followed by 2 layer cast. Under axial compression, the load bearing capacity of 8 layer POP casts was more than 2 and 3 layer cast. Conclusion: The values of load bearing capacity, stress, stiffness and MOE of cast were the highest for 8 layer POP cast followed by 2 and 3 layer cast. Use if splints with POP cast is recommended due to its poor mechanical properties.

Treatment of auricular seroma: a conservative, innovative, and effective approach.

Auricular seroma is a cystic swelling filled with serous fluid. It occurs spontaneously or following trauma. Successful treatment of the seroma remains a challenge because this disease has a high propensity for recurrence. The aim was to study the results of the Plaster of Paris (POP) cast in treatment of seroma in terms of complete resolution of swelling, recurrence, and auricular aesthesis. Prospective. Smt. Kashibai Navale Medical College and General Hospital. A total of 48 patients with auricular seroma were studied. They were treated with aspiration of the cyst followed by compression dressing with a POP cast, taking the contour of the pinna. The POP cast was kept for 3 days. The patients were followed up for 6 months for recurrence. Out of 48 patients, 43 patients had complete resolution of the swelling in a single application of the POP cast. Five patients needed 2 applications of the POP cast. Not a single patient had recurrence. Temporary discoloration or thickening of the pinna was noted in 8 patients. No major complications like perichondritis were noted. Aspiration and contour dressing using POP is an innovative and effective treatment for management of auricular seroma as it prevents surgical trauma and recurrence and gives cosmetically excellent results.