Lesson 1Balancing stability, function and complication risk: how to trade immobilization rigidity for early mobilityShows how to balance stiffness and early movement, using functional bracing, cast windows, and step-by-step immobilisation to cut down stiffness, blood clots, 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 immobilization: evidence-based timelines for pediatric distal radius, adult ankle fractures, vertebral compression fracturesSums up research-based times for immobilisation in common fractures, focusing on children's distal radius, adult ankle, and spine compression fractures, and how to adjust times based on healing, scans, pain, and getting back to normal function.
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 immobilization choicesExplains how to record immobilisation plans, discuss choices, and get informed consent, stressing shared decisions, explaining risks, legal protection, and clear talk suited to patient's understanding and 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)Sets out how fracture type, age, soft tissue condition, and other health issues like weak bones or nerve problems guide choice of cast, splint, or brace, stressing personal, 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, fiberglass, thermoplastics, padding materials, waterproof linersLooks at handling and physical traits of plaster, fibreglass, and plastic materials, plus padding and waterproof liners, noting setting times, strength, x-ray visibility, weight, shaping ability, and effects on 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 fracturesCovers best joint positions for distal radius, ankle, and spine fractures, including allowed angles and twists, and how positioning affects function, pain, long-term shape changes, and arthritis risk after injury.
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 costs and supply of casting items and removable devices, with tips for picking affordable safe options where resources are short, including reuse rules, local making, and focusing on 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 prevention when skin is damaged, covering wound care before casting, sterile methods, dressings, cast windows, and check-ups to spot smells, leaks, or dead tissue under the 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 stabilization: loads, splints vs circumferential casts, role of moldingExplains forces on fractures, comparing splints and full casts, and how three-point bending, bone pressure, and cast index help hold position and stop shifting under weight.
Types of mechanical loads on fracturesSplints versus circumferential castsPrinciples of three-point moldingCast index and sagittal-coronal balanceAvoiding loss of reduction under load
