Copyright
©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Feb 18, 2017; 8(2): 170-177
Published online Feb 18, 2017. doi: 10.5312/wjo.v8.i2.170
Published online Feb 18, 2017. doi: 10.5312/wjo.v8.i2.170
Lower limb intracast pressures generated by different types of immobilisation casts
Salma Chaudhury, Alexandra Hazlerigg, Stuart Matthews, Trauma Unit, John Radcliffe Hospital, University of Oxford, Oxford OX3 7LD, United Kingdom
Anuhya Vusirikala, Trauma and Orthopaedics Department, Royal Berkshire Hospital, Reading RG1 5AN, United Kingdom
Joseph Nguyen, Hospital for Special Surgery, New York, NY 10021, United States
Author contributions: All authors contributed to this manuscript.
Institutional review board statement: This study was reviewed by the Research and Ethics Committee at the Oxford University Hospitals who felt this study did not require ethical approval.
Informed consent statement: All subjects involved in the study gave their informed consent.
Conflict-of-interest statement: None of the authors had any conflicts of interest.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at Dryad repository, who will provide a permanent, citable and open-access home for the dataset.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Salma Chaudhury, Trauma and Orthopaedic Registrar (Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Surgery), Trauma Unit, John Radcliffe Hospital, University of Oxford, Windmill Road, Oxford OX3 7LD, United Kingdom. salmachaudhury@doctors.org.uk
Telephone: +44-740-2550800
Received: May 6, 2015
Peer-review started: May 11, 2015
First decision: July 10, 2015
Revised: November 11, 2016
Accepted: November 27, 2016
Article in press: November 29, 2016
Published online: February 18, 2017
Peer-review started: May 11, 2015
First decision: July 10, 2015
Revised: November 11, 2016
Accepted: November 27, 2016
Article in press: November 29, 2016
Published online: February 18, 2017
Core Tip
Core tip: Little information is available regarding whether different lower limb casts generate different intracast pressures and pain during swelling, increasing the risk of compartment syndrome. Increased swelling within casts was modeled by a closed water system attached to an expandable bag placed directly under different types of casts. Our study suggests that split casts generate lower intracast pressures than backslabs, which are traditionally thought to accommodate swelling better. Fibreglass casts generate significantly higher intracast pressures and pain levels than plaster of Paris casts. Judicious use of complete casts, particularly fiberglass, and backslabs may be advisable for lower limb immobilisation.