Orland Keith, Spence David
Campbell Clinic - University of Tennessee Health Sciences, Department of Orthopaedics, Memphis, TN, USA.
J Pediatr Soc North Am. 2025 Jul 3;12:100241. doi: 10.1016/j.jposna.2025.100241. eCollection 2025 Aug.
This chapter offers a guide to the principles, indications, and technical steps of cast wedging, along with tips for achieving a successful cast wedge to correct angular deformity within a cast. Cast wedging is a technique that facilitates the correction of angular deformities once a fracture has been immobilized in a cast but before the fracture has fully healed. It is commonly used early in fracture healing when there has been some displacement or loss of alignment within the cast. This technique is especially beneficial for pediatric patients, who develop early callus and possess robust periosteum, enabling the cast wedge to effectively correct deformity, prevent further deformity, and potentially eliminate the need for surgical intervention. With proper planning, patient selection, and technique, cast wedging proves to be a safe and effective method.
(1)Cast wedging can be used to correct some angular deformities in the early phase of fracture healing.(2)Fractures that may benefit from cast wedging include forearm fractures, femoral shaft fractures, and tibial shaft fractures.(3)Careful planning prior to making cuts in the cast and placing a wedge can lead to a more successful correction.
本章提供了石膏楔形截骨术的原理、适应证和技术步骤指南，以及在石膏内成功实施石膏楔形截骨术以矫正角形畸形的技巧。石膏楔形截骨术是一种在骨折已用石膏固定但尚未完全愈合时促进角形畸形矫正的技术。当石膏内出现一些移位或对线不良时，该技术通常在骨折愈合早期使用。这项技术对儿科患者尤其有益，因为他们早期形成骨痂且骨膜活跃，使石膏楔形截骨术能够有效矫正畸形、防止进一步畸形，并有可能避免手术干预。通过适当的规划、患者选择和技术操作，石膏楔形截骨术被证明是一种安全有效的方法。
（1）石膏楔形截骨术可用于在骨折愈合早期矫正一些角形畸形。（2）可能受益于石膏楔形截骨术的骨折包括前臂骨折、股骨干骨折和胫骨干骨折。（3）在石膏上切割并放置楔形物之前进行仔细规划可带来更成功的矫正。
