What is Application of Short Leg, Patellar Tendon Bearing, or Rigid Total Contact Leg Casts: Overview, Benefits, and Expected Results
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### What is Application of Short Leg, Patellar Tendon Bearing, or Rigid Total Contact Leg Casts?
Short leg, patellar tendon bearing, or rigid total contact leg casts are types of braces used to prevent and manage skeletal deformities such as clubfoot. These casts are usually worn from the knee down and are appropriate for children and adults. In some cases, they may also be used to treat other conditions such as diabetic foot ulcers and other foot and ankle fractures.
The short leg cast is designed to keep the hips, knee, and ankle in the correct alignment for a period of time while the leg heals or gradually adjusts to a new position. The patellar tendon bearing cast is similar to the short leg cast in that it aligns the hip, knee, and ankle joints to support proper healing. However, this cast applies more pressure to the patellar tendon and is designed to be more supportive than the short leg cast. The rigid total contact cast is the most supportive of all of these casting options and is best used when the patient needs the highest level of support.
### Overview
Short leg casts, patellar tendon bearing casts, and rigid total contact casts are all designed to support the extremities while a patient is overcoming a medical condition or during post-operative recovery. The type of cast used will depend on the type of condition being treated and the degree of severity. These casts provide immobilization of the lower extremities, which is necessary for proper healing and alignment.
In addition to providing support, these casts can also be used to correct deformities such as clubfoot. During the application of a short leg, patellar tendon bearing, or rigid total contact cast, the foot and ankle may be manipulated in order to re-align the bones and tendons and correct any deformities that may be present.
### Benefits
Short leg, patellar tendon bearing, or rigid total contact casts offer a number of benefits. The immobilization provided by the cast will assist in proper healing and alignment of bones and tendons, helping to correct any deformities that are present. This type of cast also helps to reduce swelling in the affected area and reduce pain associated with the condition being treated.
The casts also provide a necessary protective barrier for the affected area, shielding it from further injury and helping to prevent any injury that could be caused by everyday activities or movements. Additionally, the casts help to control the range of motion in the affected area, which is important for both healing and prevention of further injury.
### Expected Results
When a short leg, patellar tendon bearing, or rigid total contact cast is applied, the patient can expect the affected area to be completely immobilized and protected while the condition being treated heals or adjusts to the new position. Typically, the patient will be advised to limit their physical activity while the cast is in place. The length of time that the cast will be worn will depend on the type and severity of the condition and the response of the patient to the treatment.
It is important to note that the results achieved with this type of cast will vary depending on the type of condition being treated and the individual patient’s response to the treatment. The patient and their healthcare team should discuss the expected outcomes of the treatment prior to beginning the device.
### Care and Precautions
It is important to properly care for a short leg, patellar tendon bearing, or rigid total contact cast in order to ensure optimal healing and prevention of further injury. The patient should keep the cast dry and clean, avoiding any contact with water, soap, or other chemicals. The patient should also take special care when engaging in any type of physical activity in order to avoid any further injury to the affected area.
Patients should also be vigilant in monitoring for any redness, swelling, itching, or other signs of infection. If any of these signs are present, the patient should contact their healthcare team immediately. Additionally, the patient should contact their healthcare team if they experience any kind of discomfort or pain while wearing the cast.
### Conclusion
Short leg, patellar tendon bearing, or rigid total contact casts can be an effective treatment option for skeletal deformities, such as clubfoot, and can also be used for other conditions, such as diabetic foot ulcers and fractures. These casts provide immobilization of the lower extremities to promote proper healing and alignment. They also provide a protective barrier to the affected area and can help to reduce swelling and pain associated with the condition.
It is important to properly care for a cast in order to ensure optimal healing and prevention of further injury. Additionally, the patient and their healthcare team should discuss the expected results of the treatment prior to beginning. With the proper care and attention, these casts can be a successful treatment option for various conditions and deformities.
Short leg, patellar tendon bearing, or rigid total contact leg casts are types of braces used to prevent and manage skeletal deformities such as clubfoot. These casts are usually worn from the knee down and are appropriate for children and adults. In some cases, they may also be used to treat other conditions such as diabetic foot ulcers and other foot and ankle fractures.
The short leg cast is designed to keep the hips, knee, and ankle in the correct alignment for a period of time while the leg heals or gradually adjusts to a new position. The patellar tendon bearing cast is similar to the short leg cast in that it aligns the hip, knee, and ankle joints to support proper healing. However, this cast applies more pressure to the patellar tendon and is designed to be more supportive than the short leg cast. The rigid total contact cast is the most supportive of all of these casting options and is best used when the patient needs the highest level of support.
### Overview
Short leg casts, patellar tendon bearing casts, and rigid total contact casts are all designed to support the extremities while a patient is overcoming a medical condition or during post-operative recovery. The type of cast used will depend on the type of condition being treated and the degree of severity. These casts provide immobilization of the lower extremities, which is necessary for proper healing and alignment.
In addition to providing support, these casts can also be used to correct deformities such as clubfoot. During the application of a short leg, patellar tendon bearing, or rigid total contact cast, the foot and ankle may be manipulated in order to re-align the bones and tendons and correct any deformities that may be present.
### Benefits
Short leg, patellar tendon bearing, or rigid total contact casts offer a number of benefits. The immobilization provided by the cast will assist in proper healing and alignment of bones and tendons, helping to correct any deformities that are present. This type of cast also helps to reduce swelling in the affected area and reduce pain associated with the condition being treated.
The casts also provide a necessary protective barrier for the affected area, shielding it from further injury and helping to prevent any injury that could be caused by everyday activities or movements. Additionally, the casts help to control the range of motion in the affected area, which is important for both healing and prevention of further injury.
### Expected Results
When a short leg, patellar tendon bearing, or rigid total contact cast is applied, the patient can expect the affected area to be completely immobilized and protected while the condition being treated heals or adjusts to the new position. Typically, the patient will be advised to limit their physical activity while the cast is in place. The length of time that the cast will be worn will depend on the type and severity of the condition and the response of the patient to the treatment.
It is important to note that the results achieved with this type of cast will vary depending on the type of condition being treated and the individual patient’s response to the treatment. The patient and their healthcare team should discuss the expected outcomes of the treatment prior to beginning the device.
### Care and Precautions
It is important to properly care for a short leg, patellar tendon bearing, or rigid total contact cast in order to ensure optimal healing and prevention of further injury. The patient should keep the cast dry and clean, avoiding any contact with water, soap, or other chemicals. The patient should also take special care when engaging in any type of physical activity in order to avoid any further injury to the affected area.
Patients should also be vigilant in monitoring for any redness, swelling, itching, or other signs of infection. If any of these signs are present, the patient should contact their healthcare team immediately. Additionally, the patient should contact their healthcare team if they experience any kind of discomfort or pain while wearing the cast.
### Conclusion
Short leg, patellar tendon bearing, or rigid total contact casts can be an effective treatment option for skeletal deformities, such as clubfoot, and can also be used for other conditions, such as diabetic foot ulcers and fractures. These casts provide immobilization of the lower extremities to promote proper healing and alignment. They also provide a protective barrier to the affected area and can help to reduce swelling and pain associated with the condition.
It is important to properly care for a cast in order to ensure optimal healing and prevention of further injury. Additionally, the patient and their healthcare team should discuss the expected results of the treatment prior to beginning. With the proper care and attention, these casts can be a successful treatment option for various conditions and deformities.
Definition & Overview
The application of casts is a key part of treatment for broken bones or fractures. Casts help promote proper bone healing during the recovery period. They work by keeping the injured part of the body straight and without motion. Casts come in different types, such as short leg casts, patellar tendon bearing casts, and rigid total contact leg cast, among others. To prevent potential complications, casts should be worn only for the correct amount of time, which depends on the severity of the injury.
Who Should Undergo and Expected Results
The application of short leg, patellar tendon bearing, and rigid total contact leg casts is helpful for patients recovering from musculoskeletal conditions, such as:
- Fractures
- Sprains
- Reduced joint dislocations
- Severe soft tissue injuries
They can be used on almost any body part, including the arms, legs, elbows, ankles, and even the fingers.
Casts keep bones from moving while they are healing and support the injured limb during the recovery period. They also stabilize reduced, displaced, or unstable fractures before the patient seek further treatment.
Using casts offers the following benefits:
- Promote proper healing
- Keep the injured limb from unnecessary stress
- Shorten the patient’s recovery time
- Help reduce pain and swelling
Casts are made of either plaster of Paris or fiberglass. Fiberglass is a type of mouldable plastic used to make cooler and more lightweight casts than the traditionally used plaster casts.
Casts come in many different types, including:
- Short leg casts. These are appropriate for patients who suffer from lower leg, ankle, and foot injuries, such as non-displaced metatarsal or fibular fractures. The cast is applied at the metatarsal heads until 2 inches away from the fibular head. The bony parts, such as the fibular head and malleoli, are covered with additional padding. If it is the ankle, it is flexed to a neutral 90-degree position.
- Patellar tendon bearing casts. Patellar tendon bearing casts are below-knee total contact casts first developed in 1967. They are appropriate for injuries affecting the patellar and its soft tissues, such as patellar fracture, patellar dislocation, and patellar tendon rupture. They are modified versions of the short leg cast. The top of the cast has a wing-like addition that supports the knee’s medial and lateral side. The back of the cast is then cut in the back to allow the leg to flex at the crease of the patellar. These modifications were made to allow the knee to move but to keep it from rotating and worsening the injury. This cast is used by patients who are ready to begin bearing weight. It is usually worn after coming out of a long leg cast.
- Rigid total contact leg casts. A total contact cast is the primary type of cast used for diabetic patients who suffer from foot ulcers. For diabetic patients, it is important to keep the pressure on the foot ulcer low. Studies show that a rigid total contact cast put the lowest peak plantar pressure in ambulatory patients. These casts are ideal for diabetic patients with foot ulcers as long as the patient:
- Is not infected
- Has sufficient arterial flow
- Does not have pain or significant oedema
- Has a stable gait
- Does not have safety hazards and compliance issues
- Has Wagner 1 or 2 ulcers
Patients who have an active infection or compromised arterial flow are reconsidered for a total contact cast only if they have received treatment for the infection or have undergone vascular surgery.
The selection of the right cast to use depends on the following factors:
- The body part being treated
- The type of injury
- The extent of the injury
- The stability of the injury
How is the Procedure Performed?
Doctors generally follow the same steps during the application of different casts, which include short leg, patellar tendon bearing, and rigid total contact leg casts.
- The doctor first wraps the injured area with several layers of soft cotton or, in the case of a total contact cast, foam dressing. This makes up the inner layer of the cast. Sometimes, patients are also given a stockinette or a strip of felt.
- The outer layer of the cast, which is made from plaster of Paris or fibreglass, is soaked in water.
- The material is then wrapped around the injured area and the inner layer of the cast. It normally feels wet at first, but the cast will quickly harden.
- The cast is trimmed to the right size.
- Doctors may make tiny cuts on the sides of the cast to accommodate any swelling.
- A rubber or plywood walking heel is attached to the bottom of the patient’s foot.
- After the cast is applied, patients are not allowed to bear any weight for around 15 minutes or until the cast is cool and hard.
There are some special considerations depending on the type of cast being used. For the patellar tendon bearing cast, it should be applied in segments and over minimal padding. During the application, the patient is asked to flex the knee to a right angle. The doctor then molds the cast over the upper calf. This creates a triangular cross-section. The cast is then molded around the patella with a special indentation around the tendon.
For the application of a rigid total contact leg cast, the patient should be in a prone position, and the leg should be flexed at the knee. The foot should also be in a neutral position with the ankle.
Patients are given instructions on the care of the cast before being discharged.
Possible Risks and Complications
Patients who have a short leg, patellar tendon bearing, or rigid total contact leg cast placed are prone to the following symptoms or complications:
- Chronic pain
- Joint stiffness
- Muscle atrophy
- Heat injury
- Pressure sores
- Skin breakdown
- Infection
- Dermatitis
- Complex regional pain syndrome
To avoid such complications, the casts are only worn for a limited amount of time. Patients are also carefully monitored.
References:
- Boyd AS, Benjamin HJ, Asplund C. “Splints and casts: Indications and methods.” Am Fam Physician. 2009 Sep 1;80(5): 491-499. http://www.aafp.org/afp/2009/0901/p491.html
- H. Svend-Hansen, V. Bremerskov & P. Ostri (1979) Fracture-Suspending Effect of the Patellar-Tendon-Bearing Cast, Acta Orthopaedica Scandinavica, 50:2, 237-239, DOI: 10.3109/17453677908989761
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Very informative. #knowledge