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Fractures: Bone Repair

Fractures: Bone Repair

Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...

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[Treatment of equinus with serial casting].

A Fernández Gómez¹, D Hermoso de Mendoza Pi², J A Conejero Casares¹

¹Servicio de Medicina Física y Rehabilitación, Hospital Universitario Virgen Macarena, Sevilla, España.

|March 27, 2021

Summary

Serial casting effectively treats equinus in children, improving ankle range of motion. This method, even with botulinum toxin, offers sustained benefits for gait and positioning.

Keywords:

Botulinum toxin Dorsal flexion Equinismo Equinus Flexión dorsal Serial casting Toxina botulínica Yeso

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Area of Science:

Pediatric Orthopedics
Rehabilitation Medicine
Neuromuscular Disorders

Background:

Equinus gait in children leads to unsteady movement and poor wheelchair positioning.
Serial casting is a key treatment for maintaining range of motion and promoting normal motor patterns.
Optimal protocols for serial casting combined with botulinum toxin require further definition.

Purpose of the Study:

Characterize children with equinus of various causes.
Evaluate the effectiveness of serial casting treatment.
Assess the combined use of serial casting and botulinum toxin in spastic cerebral palsy.

Main Methods:

Longitudinal retrospective study of 95 children treated between 2012-2018.
Inclusion criteria: ankle dorsal flexion <10°, treated with serial casting +/- botulinum toxin.
Measurements included range of motion, spasticity, and BMI, analyzed using SPSS®.

Main Results:

Statistically significant improvement in passive dorsal flexion (10.02°) after serial casting.
This improvement was maintained at 6.66° after 14 months (P=.02).

Conclusions:

Serial casting is a highly effective treatment for equinus, regardless of the underlying cause.
The method demonstrates a low rate of complications.
Serial casting provides lasting improvements in ankle mobility for pediatric patients.