Casting and Splinting in Dogs

Casts are a form of external immobilization, custom-made to conform to the injured extremity of the canine. The casts lie in close contact with the skin, made of several layers of padding and plaster. However, other materials may be used to create a cast, including polyurethane-impregnated cotton-polyester, fiberglass, or thermal plastics. 

A splint is a rigid material used to aid in immobilization and support of a not yet set bone. The same materials used to construct casts can be used in splint creation, but thermal plastic is commonly used as it possesses the ability for reuse. Ready-made splints of aluminum or plastic are also commonly used for fractures, and are easily applied.

Casting 

Casting is conducted using aseptic technique, meaning the method used to complete a cast is designed to prevent microorganism contamination. The dog may be anesthetized and the affected area may be shaved prior to the procedure. 

The following describes casting technique used on a foreleg fracture:

1. The dog is placed in lateral recumbency (lying on the side) with the injured extremity facing down. 
2. A stirrup is created as tape is applied to the ventral and dorsal aspects of the foot. The leg is elevated and supported to maintain the elevated position for casting. 
3. A stockinette bandage may be applied if deemed necessary. 
4. Padding is applied to the elevated leg. Padding underneath the cast consists of layers that are wound tightly around the leg, starting from the distal to proximal aspects of the leg. Several layers will be applied. 
5. The cast material is rolled around the leg, from distal to proximal limb aspects, overlapping itself on each encirclement. Several layers may be applied. 
6. Wet plaster is then placed atop of the casting material and conformed to the unique shape of the leg. A slight flexion is placed in the plaster on the carpus to prevent a valgus deformity as the bone heals. 
7. Visible padding at both ends of the cast are turned downward and taped over the stirrup to aid in position maintenance of the cast. 
8. Plaster will take several hours to dry, therefore, the canine will be hospitalized overnight prior to release. 

Splinting

Splints are not total encircling devices, but aid in early immobilization when a fracture is accompanied by a great deal of swelling. 

In splinting of a foreleg fracture, strips of plaster run down the cranial and caudal aspects, bound together by a tape or elastic gauze. Splint material is chosen according to the size of the dog and length of the limb. The strips are laid on the dressing table and plaster is made wet. 

1. The wet strips are placed on the affected leg, starting from the toe to the elbow. 
2. Uniform distance is maintained between the cranial and caudal aspects, then gauze is wrapped in a circular motion around the plaster. 
3. The splint is flexed to conform to the natural bend in the extremity and tape is applied for security. 

Surgically treated fractures will heal approximately 97% of the time without complications of serious nature. The rate of healing can be as low as 50% to 95% depending on whether or not the canine is experiencing secondary complications (swelling, infection). Casting and splinting conducted by a veterinary or orthopedic veterinary profession will result in permanent fixation of the affected skeleton.

Pain medication is the norm for send-home drug therapy after a casting or splinting endeavor. However, antibiotics and anti-inflammatory drugs are also prescribed in cases of secondary damage caused by the injury (swelling or infection). 

The at-home care provided by the pet owner accounts for approximately 50% of recovery. Limbs that have been casted must be checked twice daily for effective circulation. Cold, swollen, or blue tinged toes indicate a problem and must be addressed immediately. The cast must stay impeccably clean and dry, to prevent infection. Dirty, damp or odorous casts must be changed immediately. 

Check-ups with the veterinarian and total recovery time lies dependent on the injury type. Several months of recovery time are to be expected.

Casting and splinting can be an expensive, yet highly effective treatment for fracture or breaks. It is often an available 'back up option' when surgery is not affordable or possible for whatever reason.The average cost to cast or splint an extremity is approximately $2,000, but total body casts can average up to $5,000. Ask your veterinarian about the price deemed appropriate, as prices vary depending on the condition and veterinarian.

The risks of using a cast or splint are limited in the veterinary clinic, as most risks are present at home. Improper care can pose a risk of infection, loss of circulation, necrotic tissues and delayed healing time. If the extremity was casted properly, the benefits reach the treatment goal of fixating the fractured or broken limb.

The need of casting or splinting for dogs can be prevented by taking basic safety measures. Fenced in yards, the use of a leash and keeping an eye on your dog will prevent the majority of skeletal injuries from occurring. Blunt force traumas, hit-by-car accidents, falls, and fights are the most commonly reported causes of casting needs.