Cast Wedging to Correct Fracture Angulation: Tips and Tricks.

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. Key Concepts: (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.