Plaster Of Paris Cast Research Articles

Operative Treatment of the Acutely Ruptured Lateral Ligament of the Ankle

Twenty-seven patients with acute inversion injuries of the ankle were treated surgically during the past ten years. Instability indicative of rupture of the lateral collateral ligament was demonstrated by anteroposterior stress inversion roentgenograms. Ruptures of a component or components of this ligament were found at operation in every case. The ligament and capsule were repaired and the ankle was immobilized by a plaster of Paris cast for six to eight weeks. Of 26 patients available for follow-up examination, none complained of instability although nine had minor residual symptoms. Postoperative stability was demonstrated by roentgenograms in 13 patients. In the other 13, clinical examination showed that the ankles were stable on forcible inversion of the foot and ankle. Our results indicate that surgical repair offers the best prospect for successful treatment when definite passive instability can be demonstrated by properly performed stress inversion roentgenograms.

DISUSE ATROPHY OF SKELETAL MUSCLE IN THE RAT, AGGRAVATED BY CORTISOL AND VARIOUS STRESS CONDITIONS

Slight atrophy of the triceps surae muscle of the rat was produced by immobilization of one hind limb in a plaster of Paris cast. The development of disuse atrophy was significantly aggravated when the immobilized animal was exposed to stressors and/or treated with cortisol. These results indicate that immobilization of one limb, which did not produce any visible local damage through compression, can act as a "conditioning" factor which selectively sensitizes the muscular tissue to the catabolic effect of endogenous and exogenous corticoids. It is probable that the conditioning is due to a circulatory disturbance caused by the immobilization, but this assumption has not been definitely proved. These experiments also indicate that the type of immobilization used here can act as a "neurogenic" stressor agent, and by thus producing general catabolism predisposes the muscular tissue for the development of a greater degree of atrophy.

DISUSE ATROPHY OF SKELETAL MUSCLE IN THE RAT, AGGRAVATED BY CORTISOL AND VARIOUS STRESS CONDITIONS

Slight atrophy of the triceps surae muscle of the rat was produced by immobilization of one hind limb in a plaster of Paris cast. The development of disuse atrophy was significantly aggravated when the immobilized animal was exposed to stressors and/or treated with cortisol. These results indicate that immobilization of one limb, which did not produce any visible local damage through compression, can act as a "conditioning" factor which selectively sensitizes the muscular tissue to the catabolic effect of endogenous and exogenous corticoids. It is probable that the conditioning is due to a circulatory disturbance caused by the immobilization, but this assumption has not been definitely proved. These experiments also indicate that the type of immobilization used here can act as a "neurogenic" stressor agent, and by thus producing general catabolism predisposes the muscular tissue for the development of a greater degree of atrophy.

The treatment of fractures of the patella

Simple fractures of the patella without separation of the fragments are treated by immobilization in a plaster of Paris cast. If the fragments are separated they are reduced by open operation and tied together. A loop of stainless steel wire is preferred to any other type of suture. The tear in the lateral aponeurosis is sutured with d silk. Avulsions of the quadriceps tendon or of the patellar ligament are repaired by heavy silk which is passed through two drill holes in the patella and tied at the opposite pole of the bone. The management of compound fractures, of infected fractures and of old fractures of the patella is described.