During our orthopedic training, we were taught that application of orthopedic cast (or simply “casting” to hold a reduced fracture until healing) is an art. The product – a fractured limb held into reduction by a plaster of Paris / fiberglass cast is a reflection of the quality of the surgeon applying it and the patient taking care of it. The cast speaks of its creator.
In an institution where majority of our orthopedic patients can only afford a plaster cast (Plaster of Paris a calcined Gypsum), the residents have four years and eternity to perfect this art. Needles to say, our mentors made it their vows to show the “exit doors” to any resident who don’t apply a cast well or those who couldn’t take care of any patient with a casted limb. The reason?
If you can’t apply a good cast, you probably couldn’t make a good ”cut”. 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, that cast speak of its creator and its caretaker.
It’s an art. Make it look and feel like one.