Lesson 1Balancing stability, function and complication risk: how to trade immobilisation rigidity for early mobilityExplains balancing rigidity and early movement using functional bracing, cast windows, and phased immobilisation to cut down stiffness, thrombosis, and muscle wasting while keeping fracture stable and patient safe.
Risks of over-immobilization and stiffnessWhen to allow early joint motionFunctional bracing and removable devicesStaged cast modification and wedgingMonitoring for instability during mobilizationLesson 2Duration of immobilisation: evidence-based timelines for paediatric distal radius, adult ankle fractures, vertebral compression fracturesSums up evidence-based immobilisation periods for common fractures like paediatric distal radius, adult ankle, and vertebral compression fractures, and talks about adjusting timelines based on healing, scans, pain, and functional recovery.
Bone healing phases and timelinesPediatric distal radius immobilizationAdult ankle fracture immobilizationVertebral compression fracture bracingCriteria for safe cast or brace removalLesson 3Documentation and informed consent specifics for immobilisation choicesCovers how to record immobilisation plans, explain choices, and get informed consent, stressing shared decisions, risk info, legal protection, and clear talk suited to patient's understanding and cultural background.
Essential elements of cast documentationRecording clinical indications and goalsExplaining risks, benefits, and alternativesDocumenting patient questions and teachingLegal and ethical aspects of consentLesson 4Selection criteria: fracture pattern, patient age, soft-tissue status, comorbidities (osteoporosis, neuropathy)Explains how fracture type, age, soft tissue condition, and issues like osteoporosis or neuropathy guide choice of cast, splint, or brace, focusing on customised, risk-based immobilisation plans.
Classifying fracture patterns for planningAge-related healing and immobilization needsSoft-tissue swelling and skin conditionImpact of osteoporosis on construct choiceNeuropathy and sensory risk managementLesson 5Properties of casting materials: plaster of Paris, fibreglass, thermoplastics, padding materials, waterproof linersLooks at physical and handling traits of plaster, fibreglass, thermoplastics, padding, and waterproof liners, noting setting times, strength, X-ray clarity, weight, shaping ability, and effects on patient comfort and skin safety.
Plaster of Paris: setting and strengthFiberglass: advantages and limitationsThermoplastics and custom splintsPadding types and pressure protectionWaterproof liners: use and caveatsLesson 6Joint positioning and functional alignment: acceptable angulation/rotation for distal radius, ankle, and spine fracturesDeals with proper joint positioning for distal radius, ankle, and spine fractures, including allowed angulation and rotation, and how alignment affects function, pain, long-term deformity, and arthritis risk after trauma.
Functional position of the hand and wristAcceptable distal radius angulation and tiltAnkle neutral alignment and rotation limitsSpinal alignment in compression fracturesConsequences of malalignment on functionLesson 7Cost, availability, and resource-limited alternatives for casting materials and removable devicesLooks at cost and supply of casting items and removable devices, with tips for picking affordable safe options in low-resource areas, including reuse rules, local making, and priority for key materials.
Cost drivers in casting materialsChoosing between cast and removable braceLow-cost splinting and casting optionsReuse, recycling, and safety limitsTriage of premium materials in scarcityLesson 8Infection control and sterile technique considerations when skin integrity compromisedOutlines infection control for damaged skin, covering pre-cast wound care, sterile methods, dressing picks, cast windows, and follow-up to spot smell, discharge, or tissue death under immobilisation.
Assessing wounds before immobilizationSterile technique for open injuriesChoosing dressings under casts or splintsCast windows and wound inspection plansWarning signs of infection under a castLesson 9Biomechanics of fracture stabilisation: loads, splints vs circumferential casts, role of mouldingLooks at how forces affect fractures, comparing splints and full casts, and explains how three-point moulding, bone pressure, and cast index help hold reduction and stop shifting under load.
Types of mechanical loads on fracturesSplints versus circumferential castsPrinciples of three-point moldingCast index and sagittal-coronal balanceAvoiding loss of reduction under load
