NEW APPLIANCE A METHOD OF CASTING SEVERELY DEFORMED AND DISABLED PATIENTS

MOULDED leather and plastic splints and appliances are usually prepared on a positive plaster-of-Paris mould made from a plaster-of-Paris cast of the part of the body to be splinted. The correct fit of the appliance depends very considerably on the accuracy with which the cast and mould are taken and prepared. It is usual to cast patients for spinal braces in the standing or sitting position with the head supported in an overhead sling. The amount of traction on the head sling depends on the amount of spinal collapse, the amount the patient can support himself, and the amount of traction he can tolerate. The very severely disabled patient with a severe collapsing or fixed scoliosis due, for example, to poliomyelitis or muscular dystrophy is often unable to tolerate the handling and suspension necessary for an adequate cast to be taken. Such severely disabled patients may well be able to control an electrically powered chair if they could have a support manufactured to accept them. Some can be adequately and comfortably supported by adjustable lateral pads (Nichols, 1966), and others can be made comfortable by specially designed cushions. Bu