Traditional Versus Water-resistant Short Leg Casting: A Randomized Controlled Pilot Study

We conducted a randomized controlled trial comparing fiberglass short leg casts with traditional cast padding to similar casts with water-resistant cast padding and recorded the opinion of the patient/caregiver and Orthopaedic Technicians (Ortho Techs) that applied and removed the casts.

Subjects with an injury that would be treated with a short leg cast were enrolled and randomized into a traditional cast or a water-resistant cast. Following cast application, the Ortho Tech that applied the cast completed a questionnaire asking their opinion on ease of application, moldability, padding level, and time taken for application. Following the removal of the study cast, the Ortho Tech that removed the cast completed a questionnaire that included an assessment of skin condition and evidence of the patient poking items inside the cast, as well as their opinion of ease of padding removal, padding durability and longevity, and an overall quality assessment of the cast padding. Following cast removal, the patient (or caregiver) also completed a questionnaire asking for their assessment of comfort, the weight of the cast, itchiness, heat/sweat, smell, and satisfaction. Patients who were treated with an expanded polytetrafluoroethylene cast were also asked about their happiness with the cast's water resistance and asked how long the cast took to dry.

Sixty patients were included in this study, thirty in each group. The water-resistant casts took longer to apply than the traditional casts (12.4±4.0 vs. 8.2±3.2 min, P <0.001). The Ortho Techs favored the traditional cast when it came to ease of application ( P <0.001), moldability ( P =0.003), ease of padding removal ( P <0.001), padding durability ( P =0.006), padding longevity ( P =0.005), and their overall impression ( P =0.014). The patients/caregivers responded similarly among the 2 groups for each survey question.

Patients randomized into each cast type tolerated their cast similarly; however, the Ortho Techs involved in this study preferred the traditional cast.