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Healthy You

A Cast Made from Bark or Egg Whites? We’ve Come a Long Way, Baby

Tuesday, May 03, 2022 2:03 PM

By Isabelle Banin

The Egyptians used bark wrapped in linen. The Shoshone tribe of North America favored hardened strips of rawhide. And as far back as the first millennium, a wildly inventive doctor was the first to use egg whites.

Come with us on this fascinating journey into the history of the casting and splinting methods that we owe our modern treatments to.

Of course, the Orthopaedic & Spine Institute, has a unique kinship with casting beyond the obvious. In 2019, the Institute set the Guinness World Record™ for "Largest Orthopaedic Cast" which measured 12 feet in length and 5 feet wide.

Broken Bones, Creative Cures
First, let’s travel back to 3000 B.C., when Egyptians used bark splints wrapped in linen and cast-like bandages. Ancient Greeks used waxes and resins to heal broken bones. In North America, the Shoshone tribe used hardened strips of rawhide, and in South Asia, ancient Hindus splinted fractures with bamboo.

Innovation was relentless throughout the Middle Ages, which is when egg whites became a common cast material to stiffen bandages. Other doctors in the early 1800s went an entirely different route, and encased broken limbs in wooden boxes filled with moist sand.

The Plaster Cast Arrives!
Plaster of Paris casts are made from treated gypsum powder mixed with water. This material was widely used in architecture for hundreds of years before 19th century European doctors used it in casts. Initially, doctors still used the wooden-box casting method, but filled it with plaster of Paris instead of sand. The resulting cast still took hours to dry and its hefty weight left patients bedridden. Throughout the mid-19th century, doctors introduced improvements that increased patients’ comfort and mobility, such as bandages with plaster of Paris rubbed into them.

21st Century Casting
While plaster casts are still widely used, synthetic fiberglass casts, introduced in the 1970s, are significantly stronger, lighter, breathable and waterproof!

Kirsten E. Geary, M.D., Sports Medicine, said she prefers “fiberglass casts since they are lighter, more comfortable for patients, and come in fun colors. A lot of surgeons prefer plaster, since it allows for specialized molding.”

Casts are generally used if there is not too much swelling and stays on for at least a few weeks, Dr. Geary added. Splints are used for shorter periods of time, and often for very acute injuries or when there is a high level of swelling. Your doctor will choose the best option based on your injury.

How do we remove fiberglass and plaster casts? Dr. Geary said clinicians use an oscillating cast saw. The vibrating blade cuts only the cast’s exterior, not the interior padding.

If you are injured and believe you need immediate treatment, walk-in visits are accepted at our Orthopaedic & Spine Immediate Care locations. Learn more about when to visit an Immediate Care Center or an Emergency Department here.