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Journal of Bone and Joint Surgery, 1967;49:855-875.
© 1967 by The Journal of Bone and Joint Surgery, Inc

A Functional Below-the-Knee Cast for Tibial Fractures

AUGUSTO SARMIENTO M.D.1

1 From the Division of Orthopaedics, Department of Surgery, University of Miami School of Medicine, Jackson Memorial Hospital, Miami

1. An experimental method of treatment for fractures of the tibia with a below-the-knee total-contact weight-bearing cast are discussed.

2. The success of this method appears to depend on the careful application and molding of plaster to the fractured leg after swelling has been reduced to a minimum and closed reduction has been obtained. Good alignment is essential, but slight shortening or overriding of fragments can be accepted with the expectation that little or no increase in the amount of shortening will occur.

3. The results obtained indicate that this type of cast not only holds reduction well but permits healing of fractures of the tibia in a relatively short period of time. The maintenance of the limb in a near-physiological condition throughout the entire reparative process is offered as an explanation for rapid healing.

4. Treatment of tibial fractures by this method has the advantage of retaining functional activity of the extremity during healing and of eliminating the need for extensive rehabilitation of the knee and thigh muscles after healing has occurred.


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