Revolution in orthopedic immobilization materials: A comprehensive review

Ekanayake, C.; Gamage, J.C.P.H.; Mendis, Priyan; Weerasinghe, P.

doi:10.1016/j.heliyon.2023.e13640

Cited by 13 publications

(10 citation statements)

References 85 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Alternatively, utilizing a stockinette on the affected area followed by wrapping in synthetic cotton padding ensures that skin-irritating materials do not directly contact the skin, thus minimizing the risk of sensitization. Fiberglass casts offer advantages such as increased porosity compared to plaster casts, reducing the vulnerability of the skin underneath the cast to irritation [ 13 ]. Our patient experienced ACD resulting from the cotton used in the splint.…”

Section: Discussionmentioning

confidence: 99%

Allergic Contact Dermatitis in the Right Forearm Following Splint Application for Distal Radius Fracture: A Rare Case of Plaster Cotton Allergy

Değer,

Demirdas,

Akbaba

et al. 2024

Cureus

View full text Add to dashboard Cite

Allergic contact dermatitis (ACD) after splint or cast application (plaster of Paris) is infrequently encountered in orthopedic and traumatology clinical practice. This case study aims to elucidate the identification of ACD after splint application, highlight the conditions that warrant vigilance, and outline the precautions and optional treatment methods available in such instances. A 56-year-old right-hand dominant female presented to the emergency department after a fall on her right hand, manifesting pain, swelling, and tenderness without neurovascular injury. Radiographs revealed a distal radius fracture, leading to the application of a plaster of Paris splint. Within one day, she returned to the emergency department with severe itching and burning in the right arm. The splint was removed, and a dermatology consultation confirmed ACD due to undercast cotton padding. After splint removal, the patient's fracture treatment continued using a shoulder-arm sling until the lesion healed. Topical antihistamine ointment and oral corticosteroids were prescribed. Regular follow-up revealed the healing and union of the fracture by the fifth week, with minimal residual skin color changes. This case underscores the importance of prompt diagnosis and appropriate treatment in managing such occurrences. A key takeaway is the crucial need to schedule a follow-up appointment with the patient within one day of applying the cast or splint. Skin problems can emerge rather than neurovascular issues following casts or splints. Educating patients on warning signs, including skin irritation, neurovascular deficits, and symptoms of compartment syndrome, ensures the timely identification of significant issues. Healthcare practitioners should inquire about patients' histories of allergic skin reactions, taking a proactive approach to prevent ACD through early intervention and preventive measures.

show abstract

Section: Discussionmentioning

confidence: 99%

Allergic Contact Dermatitis in the Right Forearm Following Splint Application for Distal Radius Fracture: A Rare Case of Plaster Cotton Allergy

Değer,

Demirdas,

Akbaba

et al. 2024

Cureus

View full text Add to dashboard Cite

show abstract

“…The 15-min test was used to establish a minimum amount of isocyanate exposure, as this is the minimum time period for which the SafeAir tag is approved. Thereafter, the 1-h exposure could be the equivalent of what the patient experiences during the cast application process and likely approaches the time period required for the cast to set such that it may bear weight, while the 24-h test in our experiments intends to simulate the repeated exposure of the medical personnel responsible for casting to isocyanates [ 37 ]. This allowed us to gain a unique insight into isocyanate release from a single cast over various time periods.…”

Section: Discussionmentioning

confidence: 99%

“…Despite rapid progress in orthopedic medical technologies over the past 20 years, traditional casts made of plaster or fiberglass have remained a mainstay for limb immobilization [ 34 , 35 , 36 ]. The fiberglass tape used in such casts is impregnated with polyurethane, thereby presenting health risks to clinical staff given the frequent occupational exposure to isocyanates (see Figure 1 C) [ 37 ]. Moreover, traditional casting methodology is limited by its water-sensitive nature, leaving patients at risk of complications ranging from minor skin irritation to compartment syndrome should their cast become wet, requiring the reapplication of the cast or further treatment [ 38 , 39 ].…”

Section: Introductionmentioning

confidence: 99%

Reduced Isocyanate Release Using a Waterproof, Resin-Based Cast Alternative Relative to Fiberglass Casts

Stefanescu,

Timlin,

Moy

et al. 2023

Toxics

View full text Add to dashboard Cite

The effects of occupational isocyanate exposure range from asthma and contact dermatitis to neurotoxicity and cancer. Respiratory sensitization due to orthopedic cast application has been well documented. This study aims to compare the safety of standard-of-care fiberglass casts and a novel waterproof cast alternative by measuring the amount of isocyanate released during off-gassing over time. A 3D-printed arm simulator with comparable casing material amounts was placed in a sealed chamber. An isocyanate-sensing color-changing (SafeAir) tag was used to measure the levels of toxic exposure. Triplicate trials were conducted across all time periods (15 min, 1 h, and 24 h) and conditions. The bare arm simulator and freshly opened tags served as negative controls. Normalized pixel intensity indexes and isocyanate release estimates in ppb were derived from ImageJ-analyzed SafeAir tag photos. Fiberglass casts exhibited greater isocyanate release than both the waterproof alternative (p = 0.0002) and no-cast controls (p = 0.0006), particularly at 24 h. The waterproof alternative and no-cast control did not statistically differ (p = 0.1603). Therefore, the waterproof alternative released less isocyanate than the fiberglass casts. Waterproof cast alternatives may be safer than fiberglass by limiting medical professionals’ exposure to toxic isocyanates and, thus, decreasing their risk of suffering occupational asthma.

show abstract

“…Their lightweight nature enhances patient comfort, and the often radiolucent material allows healthcare professionals to assess the affected area without removal. Moreover, thermoplastic splints are durable and resistant to wear, ensuring prolonged and effective use in orthopedic and rehabilitation scenarios [ 7 , 8 ].…”

Section: Technical Reportmentioning

confidence: 99%

“…Additional components, such as Velcro straps or padding, may be added to improve fixation and overall comfort during use. The final step involves a thorough evaluation of the fit, comfort, and immobilization provided by the thermoplastic splint, ensuring its effectiveness in clinical orthopedic and rehabilitation applications [ 8 , 9 ].…”

Section: Technical Reportmentioning

confidence: 99%

Self-Assisted Finger Stiffness Splint (SFSS)

Almigdad,

Obeidat,

Melhem

et al. 2024

Cureus

View full text Add to dashboard Cite

Finger stiffness may arise from injuries, surgeries, or hand-related medical conditions, impacting hand function and overall well-being in daily life. Rehabilitation and hand therapy play a crucial role in restoring optimal range of motion, strength, and functionality. This article introduces the Self-Assisted Finger Stiffness Splint (SFSS), a dynamic splint designed for active finger movement applicable in post-trauma or postoperative rehabilitation. SFSS empowers patients to perform self-administered stretching exercises, expediting recovery and improving compliance. Its versatility extends to postoperative rehabilitation, covering cases like tenolysis of extensor tendons or rehabilitation after fracture healing. While particularly effective for proximal interphalangeal joint (PIPJ) and metacarpophalangeal joint (MCPJ) stiffness, SFSS remains valuable for managing isolated finger stiffness and proves beneficial in addressing multiple-digit stiffness.

show abstract

Revolution in orthopedic immobilization materials: A comprehensive review

Cited by 13 publications

References 85 publications

Allergic Contact Dermatitis in the Right Forearm Following Splint Application for Distal Radius Fracture: A Rare Case of Plaster Cotton Allergy

Allergic Contact Dermatitis in the Right Forearm Following Splint Application for Distal Radius Fracture: A Rare Case of Plaster Cotton Allergy

Reduced Isocyanate Release Using a Waterproof, Resin-Based Cast Alternative Relative to Fiberglass Casts

Self-Assisted Finger Stiffness Splint (SFSS)

Contact Info

Product

Resources

About