Lesson 1Balancing stability, function and complication risk: how to trade immobilization rigidity for early mobilityShows how to mix strong holding with early movement, using things like working braces, cast openings, and step-by-step holding to cut down stiffness, blood clots, and muscle weakness while keeping the break safe for the patient.
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 fracturesGives clear times for holding common breaks based on studies, like kids' wrist breaks, grown-up ankle breaks, and spine squeezes, and talks about changing times by healing signs, scans, pain, and getting back to normal.
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 write down holding plans, tell patients their choices, and get their okay, stressing working together, sharing dangers, legal safety, and talking in ways that fit the 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)Tells how break shape, age, skin and tissue state, and health issues like weak bones or nerve problems help pick casts, splints, or braces, focusing on plans made just for the person and their risks.
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 how plaster, fiberglass, plastic casts, padding, and water-safe covers work, including dry times, strength, see-through for x-rays, weight, shaping, and how they help keep patients comfy and skin safe.
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 right joint places for wrist, ankle, and back breaks, what angles and turns are okay, and how placing affects use, hurt, future shape problems, and joint wear later.
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 devicesChecks costs and getting supplies for casts and take-off devices, with ideas for cheap safe choices where resources are few, like reusing, making local, and picking key items first.
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 compromisedGives steps to stop infections when skin is hurt, like wound care before cast, clean methods, dressings, cast windows, and checks for smells, leaks, or dead skin under the hold.
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 moldingLooks at forces on breaks, splints against full-round casts, and how three-point bending, bone pressure, and cast shape keep fixes in place and stop shifts 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
