Lesson 1Balancing stability, function and complication risk: how to trade immobilisation rigidity for early mobilityExplains how to balance rigidity with early movement, using functional bracing, cast windows, and staged immobilisation to cut down on stiffness, blood clots, and muscle wasting while keeping fracture stability and patient safety.
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 fracturesSummarises evidence-based immobilisation times for common fractures, focusing on kids' distal radius, adult ankle, and vertebral compression fractures, and how to adjust timelines 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 immobilisation choicesDetails how to record immobilisation plans, explain choices, and get informed consent, stressing shared decisions, risk explanations, legal protection, and clear talk suited to 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)Outlines how fracture type, age, soft tissue condition, and other health issues like osteoporosis and nerve problems guide picking casts, splints, or braces, with a focus on personalised, risk-based immobilisation.
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 the physical and handling qualities of plaster, fibreglass, and thermoplastics, 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 proper joint positions for distal radius, ankle, and spine fractures, including allowed angles and twists, and how alignment affects function, pain, long-term deformity, 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 devicesExamines costs and availability of casting supplies and removable devices, with tips for picking affordable, safe options in low-resource areas, including reuse rules, local making, and prioritising 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 pre-cast wound care, sterile methods, dressings, cast windows, and check-ups for 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 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 reductions 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
