RT Journal
A1 DeMaio, Marlene
A1 McHale, Kathleen
A1 Lenhart, Martha
A1 Garland, Joshua
A1 McIlvaine, Christopher
A1 Rhode, Michael
T1 Plaster: Our Orthopaedic HeritageAAOS Exhibit Selection
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 2012
FD October 17
VO 94
IS 20
SP e152 1
OP 8
DO 10.2106/JBJS.L.00183
UL http://dx.doi.org/10.2106/JBJS.L.00183
AB Background: 
  Plaster has been used for centuries as a stiffening agent to treat fractures and other musculoskeletal conditions that require rest, immobilization, or correction of a deformity. Despite modern metallurgy and internal stabilization, plaster casts and splints remain an important means of external stabilization. Casting is a dying art as modern internal and external fixation replace external immobilization. Proper casting technique is paramount. This manuscript outlines the history and chemistry of immobilization materials and techniques as well as the differences among them and the advantages and disadvantages of each.Methods: 
  Historical references, peer-reviewed journals, textbooks, and primary sources were reviewed to provide data for this review.Results: 
  The history of immobilization reveals a progressive development and refinement of materials that culminated in Mathijsen’s plaster bandage in 1851. In 1798, calcium sulfate (plaster of Paris) was introduced. By 1927, crinoline rolls dipped in plaster treated with binding agents facilitated application. Synthetic casting “tapes” (45% polyurethane resin and 55% fiberglass) were introduced in the 1970s. Splinting techniques are ancient, with development spurred by treatment of war wounds. Plaster relies on soft-tissue contact to maintain rigidity. There are well-known advantages, disadvantages, and complications of plaster management. Casting materials all create an exothermic reaction. Burns are associated with water temperatures of >24°C, more than eight layers (ply), and inadequate ventilation. The maximum water temperature must be lower with fiberglass casts. Plaster was the definitive management for most fractures for over 100 years until it was replaced by modern surgical techniques involving internal fixation in the latter part of the twentieth century.Conclusions: 
  Plaster casts and splints remain an important treatment method for acute and chronic orthopaedic conditions.