Serial Casting

What is serial casting?

Serial casting is a technique applied to improve the mobility of stiff joints through progressive casting.

During this process, a series of casts (often made with a hybrid mesh material that is water repellent and well-ventilated) are applied over a period of time, with each subsequent cast gradually adjusting the position of the joint to its desired alignment.

The casts are changed progressively as the patient’s range of motion improves, hence the term "serial."

Why do you need serial casting?

Serial casting is applied to increase the flexibility of muscles in conditions such as stroke, spinal injuries, traumatic brain injury, and any other conditions that affects the muscle flexibility to various joints, such as those in the elbow, wrist, knee, and ankle.

It can benefit:

• Children with congenital conditions: Many congenital conditions, such as clubfoot, are identified and treated in infancy or early childhood. Serial casting can be especially beneficial in these young patients, as their bones and joints are still developing and can be more easily realigned.

• Patients with neuromuscular disorders: Those suffering from conditions like cerebral palsy, stroke, traumatic brain injury, or spinal cord injury may experience muscle imbalances or contractures. Serial casting provides a non-invasive approach to address the complications.

• Post-operative patients: Individuals who've undergone surgeries for tendon releases, joint corrections, or other orthopaedic interventions might require serial casting to maintain the surgical correction and optimise the healing process.

• Individuals with acquired contractures: This might be due to prolonged immobility, burns, or other traumatic injuries where the muscle or joint has lost its normal range of movement.

What can you expect during serial casting?

• Assessment: Before beginning the serial casting process, a thorough assessment of the affected joint's current range of motion, skin condition, and overall health, is performed.

• Cast application: The first cast is applied in a position that provides a gentle stretch to the affected joint. It's crucial that this doesn't cause pain or extreme discomfort.

• Regular monitoring: While the cast is on, regular check-ups will ensure there's no undue pressure, skin irritation, or other complications.

• Cast change: Typically every week, the cast will be removed, the joint reassessed, and a new cast will be applied that further adjusts the joint's position.

• Physical therapy: Once the final cast is removed, physical therapy is often recommended to strengthen the muscles, maintain the gained range of motion, and ensure long-lasting results.

• Potential side effects: Skin irritation or swelling might occur. Regular check-ups help in early detection and management of these potential side effects.

• Duration: The entire process's duration varies based on the severity of the contracture or deformity and individual patient factors. However, it generally spans several weeks.

In conclusion, serial casting is a non-invasive technique used to address joint deformities and improve mobility. It's essential to work closely with physiotherapists throughout the process to achieve the best outcomes.