A theoretical analysis of cast wedging with practical applications.

Cast wedging using vector and geometrical analysis demonstrated that the open wedge produces distraction of the fracture, the closing wedge shortening, and that the opening--closing wedge can perfectly correct skeletal deformity. The level of wedging should lie at the axis intersection, i.e., at the intersection of the long axes of the 2 major fracture fragments. An open wedge at the axis intersection is recommended for tibial shaft fractures immobilized with long leg casts; an opening--closing wedge at the axis intersection, for fractures immobilized with "pins and plaster".