Experience with the below-knee total-contact cast in the management of tibial fractures.

The method of application of the below-knee total-contact cast is illustrated, stressing the importance of firm moulding over the medial flare of the tibia, the popliteal space and the patellar tendon. Forty patients with tibial shaft fractures treated in this manner in Middlemore Hospital during the past four years are reviewed, and a comparison of some features is made with those of forty similar fractures treated in conventional above-knee plasters. The results indicate that a well-applied total contact case controls these fractures adequately and that convalescence is relatively straighforward. In addition, there are obvious advantages to the patient in respect of comfort and mobility.