The effectiveness of bivalving, cast spreading, and webril cutting to reduce cast pressure in a fiberglass short arm cast

The Journal of Bone and Joint Surgery. American Volume
Christian J ZainoRobert Pivec

Abstract

A fiberglass short arm cast can be used to treat a distal radial fracture, but posttraumatic edema may lead to excessive cast tightness and resultant soft-tissue injury. We sought to quantify a simulated edema-induced pressure within a fiberglass short arm cast and to determine the effectiveness of different cast-cutting methods for pressure reduction. We hypothesized that cast cutting could eliminate all clinically relevant pressure and Ace wrap would insignificantly increase pressure. Skin surface pressure under fiberglass short arm casts was measured on ninety wrists from forty-five volunteers randomly assigned to one cast-cutting method: single-cut (cast bivalve and Ace wrap), double-cut (cast bivalve, spread, and Ace wrap), or triple-cut (cast bivalve, spread, Webril cut, and Ace wrap). Each wrist was immobilized in a cast in the neutral position with one roll of 2-inch (5.1-cm) cotton Webril and one roll of 2-inch (5.1-cm) fiberglass. Each fiberglass short arm cast contained an empty intravenous fluid bag in which we infused air. This simulated edema, which generated a skin surface pressure, which was measured by a pressure transducer. Each cast-cutting method significantly reduced (p < 0.0001) the skin surface pressure f...Continue Reading

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Citations

Sep 7, 2018·Hand : Official Journal of the American Association for Hand Surgery·Nikhil Adapa, Kanu S Goyal
Feb 28, 2017·Journal of Pediatric Orthopedics·Kevin KleisEric W Edmonds
Jun 26, 2020·Journal of Children's Orthopaedics·Blake K MontgomerySteven L Frick
Jul 25, 2018·Acta ortopedica brasileira·Vinícius Ynoe DE MoraesFlávio Faloppa
Jan 19, 2021·Revue de l'infirmière·Isabelle ReboursCamille Choufani
Jun 7, 2019·Journal of Pediatric Orthopedics·Kevin KleisEric W Edmonds

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