Backslabs and plaster casts: which will best accommodate increasing intracompartmental pressures?

Plaster-of-Paris backslabs are presently used after closed or operative reduction of fractures as they are thought to accommodate any swelling which may occur. This study was designed to examine the ability of different types of cast to expand with increasing internal pressure. The results of the study show clearly that a split and spread cast is the only safe cast to use after fracture as it allows for swelling. Backslabs are no better than a complete plaster at accommodating increased internal pressure. It is therefore recommended that backslabs are no longer used to maintain reductions when swelling is anticipated.