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The Boston technique for acute point-of-care single-practitioner fracture stabilization of the lower extremity

Authors :
Robert L. Parisien
Kenneth J. McAlpine
Source :
Patient Safety in Surgery, Vol 13, Iss 1, Pp 1-5 (2019)
Publication Year :
2019
Publisher :
BMC, 2019.

Abstract

Abstract Background Closed reduction with long leg casting is a widely practiced method of acute management of lower extremity fractures but may be cumbersome and time consuming. To our knowledge, only one method of single practitioner long leg casting has been previously reported. In this report, we describe the novel single-practitioner technique utilized at our institution for acute point-of-care temporizing management of lower extremity fractures. The Boston technique The patient is placed supine at the edge of the hospital bed. The injured extremity is suspended from an intravenous pole in 45° of hip abduction and 30° of hip flexion. Neutral rotation is adequately maintained due to suspension through the great and second toes, without the need for patient participation. A plaster cast is applied in the usual manner and allowed to dry. Once dry, the cast is bivalved per our standard protocol to mitigate the incidence of compartment syndrome and soft-tissue complications. Discussion The Boston technique is recommended as a single practitioner method of lower extremity fracture casting in the emergency department, trauma bay or intensive care setting. However, future studies and inclusion of additional comparable novel casting methods are required to validate our empirical findings and to further characterize the benefits and risks of casting via the Boston technique.

Details

Language :
English
ISSN :
17549493
Volume :
13
Issue :
1
Database :
Directory of Open Access Journals
Journal :
Patient Safety in Surgery
Publication Type :
Academic Journal
Accession number :
edsdoj.38a7af343a0544249e52eedc8810399f
Document Type :
article
Full Text :
https://doi.org/10.1186/s13037-019-0200-x