ISSN 2398-2950      

Fracture fixation: casts

ffelis
Contributor(s):

James Cook

J Yovich

Synonym(s): Cast, Splint, External fixation


Introduction

  • To stabilize a fracture using a rigid cast until healing is complete.

Uses

  • Simple, transverse fractures of the bone(s) of an extremity, with little distraction, which are easy to reduce, are relatively stable on reduction and where the joints both proximal and distal to the fracture can be immobilized in the cast Fracture: overview.
  • Usually young animals where fracture healing expected to be rapid.
  • Greenstick fractures.
  • Open fractures where access to skin wounds is necessary ('Half' casts, Acrylic cast.) External fixation a much better choice in this situation as it provides excellent stability. Fracture not subject to movement (as with cast removal) at each dressing change. Frequent destabilization impedes neovascularization, delays callus formation   →   non-union/delayed union.

Advantages

  • Relatively cheap.
  • Maintain 'closed' nature of injury.
  • Relatively short general anesthesia required.
  • Acrylic casts are lightweight but strong.
  • 'Half' casts allow for wound treatment.

Disadvantages

  • Casts prevent normal limb movement.
  • Plaster casts are heavy and restrict general activity.
  • Plaster casts are not water proof.
  • Casts do not allow for compression of fracture site - healing may be slow with large callus formation.
  • There is a fine balance between maintaining rigid stability, a close fit, and avoiding pressure sores/abrasions from too tight a fit.
  • Only suitable for extremities where the joints both distal and proximal to the fracture can be immobilized by the cast.
  • Should recheck weekly -possibility of poor owner compliance.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Good when correctly applied.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Oakley R E (1999) External coaptation. Vet Clin North Am Small Anim Pract 29 (5), 1083-1095 PubMed.

Other sources of information

  • Bojrab M J & Birchard S J (1990) Eds Current techniques in Small Animal Surgery. 3rd edition, Lea & Febiger. ISBN:0 812 1119 31.
  • Slatter D H (1993) Textbook of Small Animal Surgery. 2nd edition, W B Saunders; ISBN:0 721 6833 04.

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