Orthopedic Casting is an Art

in Orthopedics by

Orthopedic casting is the procedure of applying an encasement, usually made of plaster,  to hold a “reduced” fracture in place until bone healing is confirmed.

For orthopedist, casting is a must learn skill during training. Most prolific orthopedist I knew and emulate are masters of orthopedic casting. In fact they consider “casting” as an art. The end product – fractured limb held into reduction by an encasement of either Plaster of Paris or fiberglass cast, is a reflection of the quality of the surgeon.  The cast speaks of its creator.

A poorly applied plaster cast, with grafitis all over, the ankle plantar flexed and the cast already loose. In this picture about to be cut opened and probably be replaced.
A poorly applied plaster cast, with grafitis all over, the ankle plantar flexed and the cast already loose. About to be cut open in this picture and probably be replaced.

This is the main reason why mentors take great lengths training residents in the art of casting, as well as taking care of the patient with a cast. In an institution where majority of our orthopedic patients could only afford a plaster cast (Plaster of Paris, a calcined Gypsum), the residents have four years of eternity to perfect this art. Needles to say, our mentors vowed to show the “exit doors” to any resident who don’t apply cast well or those who couldn’t care patients with a casted limb. The reason?

Patient care.

If you can’t apply a good cast, you probably couldn’t take care of your patient as well. This two notions are interrelated and is inseparable.If you can’t advice your patient to take care of their cast well, you better not put any cast on him or her as this will probably aggravate his or her orthopedic problem.

It’s a privilege rather, to apply a cast. Not everyone can apply a cast. Anybody who doesn’t know about cast care and complications should NOT even attempt to apply a cast.

So if you encounter a patient with a casted limb, the status of that cast speak of its creator.  If you’re applying a cast, apply it to perfection. It’s an art. Make it look  like one.

Dr. Remo-tito Aguilar co-founded #HealthXPh. A board certified orthopedic surgeon, he is Chief of Clinics at General Santos Medical Center and Medical Specialist II Orthopedics at the Southern Philippines Medical Center in Davao City. Dr. Aguilar is a healthcare social media evangelist and writes his medical musings at The Cast & Curious (www.remomd.com).