The plaster has long remained the only recourse to “fix” a fracture or a sprain. In the case of serious fractures, severe sprains or post-surgical repairs, the plaster has no equivalent, because it allows the part of the body concerned to be completely immobilized. It is also a way of protecting the patient, especially children, from themselves by preventing any unwanted movements. But easier-to-live-with alternative solutions are developing. To the point of dethroning plaster strips? Not necessarily… We’ll explain.
Current alternatives
– Resin, waterproof and breathable. In cases of fractures, sprains, dislocations and orthopedic surgeries, resin strips offer a lightweight alternative to traditional immobilization, which is important in the elderly and children. Once wet, they conform to the shape of the limb then harden more quickly than plaster. Additionally waterproof, but breathable for the skin, they allow brief showers, while wet plaster becomes fragile and causes irritation, mold, and therefore odors. Finally, the resin being radiotransparent, it is therefore compatible with imaging examinations.
– Removable boots, to walk again faster. Prescribed after sprain repair surgery or, to a lesser extent, after a muscle tear, walking boots are hard plastic immobilizer orthoses, furnished with a padded lining and straps. Here again, they replace the plaster, previously issued for six weeks without allowing support. However, specifies Professor Frank Duteille, head of the burns and plastic surgery department at Nantes University Hospital, “the sprain does not require strict immobilization, unlike the fracture. All you need to do is avoid lateral movement of the ankle, so that the ligaments heal in the correct position.”. The removable part of the boot makes it easy to remove for cleaning or care.
The innovations
– FlexiOH, positionable then hardening. Intended to make patients’ daily lives easier, this large perforated polymer grid device immobilizes broken limbs. It is positioned on the fractured limb then zipped. A blue (UV) lamp is then applied for 3 to 10 minutes, which hardens the orthosis. “This system applies to certain fractures such as non-displaced wrist fractures, which allows a gradual return to activitiesspecifies Professor Duteille. But its use may be limited for more complex fractures.” FlexiOH is light and breathable, compatible with the production of x-rays and scanners and it supports water. Finally, another advantage: it avoids compartment syndromes, that is to say the compression of muscle masses by a cast that is immediately too tight, or which becomes tight after the appearance of edema (blocking blood circulation). .
– 3D printed orthotics, to be improved… The innovation is interesting, but for the moment, the manufacturing of these ultra-personalized orthoses is expensive, requires several hours and must be done in contact with the fractured limb. However, immobilizing a fracture in the correct position for a long time is rarely possible. At the current stage of their development, they are therefore mainly used for research purposes and possibly in very specific situations, like osteotomies (when the bone is severed) or pathologies requiring progressive corrections.