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The Journal of Bone and Joint Surgery (American). 2004;86:2777
© 2004 The Journal of Bone and Joint Surgery, Inc.

JBJS Classic

A Functional Below-the-Knee Cast for Tibial Fractures

Augusto Sarmiento, MD

Appeared in JBJS Vol. 49-A, pp. 855-875, July 1967

Many classic, landmark articles have been published in The Journal in the past. Quarterly, we will be publishing summaries of selected articles, along with a contemporary commentary by a knowledgeable member of the editorial board identifying the article's significance in orthopaedics and its continuing relevance to our practices. Please let us know of a classic Journal article that you believe should be summarized and commented upon in the future.

J.D.H.

Abstract

An experimental method of treating tibial fractures with use of the below-theknee total-contact weight-bearing cast is discussed. The success of this method appears to depend on the careful application and molding of plaster to the fractured leg after the swelling has been reduced to a minimum and a 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. The results obtained indicate that this type of cast not only holds reduction well but also permits healing of tibial fractures 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. Treatment of tibial fractures by this method offers the advantages of retaining functional activity of the extremity during healing and eliminating the need for extensive rehabilitation of the knee and thigh muscles after healing has occurred.


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