New Dress Code: Does the Material Used to Circumferentially Secure Cast Spacers Affect Cast Compliance?

Area of Science:

• Orthopedic biomechanics
• Biomaterials science

Background:

• Fiberglass casts can increase internal pressure due to edema, risking complications.
• Univalve casts with spacers accommodate swelling, but spacer security methods vary.
• Investigating the compliance of valved casts secured with different materials is crucial for patient outcomes.

Purpose of the Study:

• To evaluate the compliance (flexibility under pressure) of a valved cast system.
• To compare the compliance when cast spacers are secured with plastic tape, silk tape, or cohesive bandage.
• To determine if material choice affects the cast's ability to accommodate swelling.

Main Methods:

• A simulated edema model using a saline bag within a fiberglass cast was created.
• The cast was univalved, and 6 mm cast spacers were secured with plastic tape, silk tape, or cohesive bandage.
• Cast compliance was measured by inflating the saline bag and recording pressure changes, with a control group using no securing material.

Main Results:

• The control group exhibited the highest average compliance (2.80 mL/mm Hg), while plastic tape showed the lowest (2.47 mL/mm Hg).
• Plastic tape significantly reduced cast compliance compared to the control (P=0.025).
• Cohesive bandage compliance was noninferior to plastic and silk tape, indicating comparable performance.

Conclusions:

• Plastic tape resulted in the lowest cast compliance, whereas cohesive bandage demonstrated the highest.
• Observed differences in compliance between securing materials were not clinically significant.
• Material selection for securing cast spacers can be based on provider preference due to minimal clinical impact.