I know this is a dumb question but do physiatrists have to know how to splint and cast? I would think they do as in MSK PMR clinic they see many fractures, injuries, etc. that need immobilization. Is this a part of PMR residency training or do they refer to ortho every single splint/cast? Thanks much.
Casting Splinting
- Thread starter pmr222b
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Actual fabrication/application of casts/splints not really. Although there may be some attendings out there that personally apply serial casting for spasticity. Kinda fallen by the wayside with the use of botulinum toxins.
We dont do too much fracture management, but splinting for soft tissue injury certainly. Youll learn the different types and indications for static/dynamic splints and braces. For example: thumb spicas, ulnar gutter, CTS, tenodesis splints. Functional knee braces vs. unloaders vs. immobilizers. Different types of ankle-foot orthoses. Cervical collars. You get the idea. As a physiatrist you should be able to assess if the brace you prescribe is doing what its supposed to do.
We dont do too much fracture management, but splinting for soft tissue injury certainly. Youll learn the different types and indications for static/dynamic splints and braces. For example: thumb spicas, ulnar gutter, CTS, tenodesis splints. Functional knee braces vs. unloaders vs. immobilizers. Different types of ankle-foot orthoses. Cervical collars. You get the idea. As a physiatrist you should be able to assess if the brace you prescribe is doing what its supposed to do.
That depends upon your preference. Learning to apply a basic upper limb cast for certain non displaced fractures can go a long way in building community awareness. In the rural setting where I work, I sometimes have patients come see me with uncomplicated fractures. I will try to get them to ortho for political reasons, but if they are not readily available (there is only 3 ortho docs in my community) I will cast them myself. Keeping some fiberglass cast material around is cheap, and casting a colles fracture is very easy. If you don't learn it during residency (I did), your ortho colleagues would be happy to teach you (if it means more OR time for them).
IMHO this is an easy skill that will help build a MSK practice, especially if you are in an underserved area. (heck, in my town, many of the FP's cast people themselves)
IMHO this is an easy skill that will help build a MSK practice, especially if you are in an underserved area. (heck, in my town, many of the FP's cast people themselves)
