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Focused rigidity casting: a prospective randomised study
Cohen AP, Shaw DL
Journal of the Royal College of Surgeons of Edinburgh 2001 Oct;46(5):265-270
clinical trial
3/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: No. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

Focused rigidity casting was compared with standard casting in a randomised prospective study. Two hundred consecutive patients attending a fracture clinic were assigned to have either a standard cast consisting of synthetic or plaster of paris, or a focused rigidity cast of synthetic material. Patients were assessed using a specially developed scoring system termed the Bradford Plaster Index. In patients with fractures of the base of fifth metatarsal, focused rigidity casting proved superior to traditional techniques for ability score (p = 0.0001), satisfaction score (p = 0.0023), overall impairment of function (p = 0.019), limitation of movement following cast removal (p = 0.024) and in limitation of muscle strength following cast removal (p = 0.001). In fractures of the distal radius, focused rigidity casting was superior for ability score (p = 0.0002) and satisfaction score (p = 0.00009). Patients with scaphoid fractures were better for satisfaction score (p = 0.0483). Compared with the standard technique, focused rigidity casting has been shown to be superior to traditional methods with regard to satisfaction and functional scores without any detriment to clinical results.

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