title: Treatment of pressure ulcers by serial casting in patients with severe spasticity of cerebral origin.
abstract: OBJECTIVE
  To assess the effectiveness of serial casting in the treatment of pressure ulcers caused by severe spasticity.
  
  
  METHODS
  Case series.
  
  
  METHODS
  A clinic for the rehabilitation of persons with neurologic disorders.
  
  
  METHODS
  Nine patients with 11 pressure ulcers resulting from severe cerebral spasticity, the ulcers being intractable to conventional management because of repeated friction and/or inaccessibility.
  
  
  METHODS
  Serial casting of the limb(s) with the pressure ulcer(s), with either fenestration or a cast arch providing access to the wound.
  
  
  METHODS
  Improved healing of pressure ulcers, as quantified with the National Pressure Ulcer Advisory Panel classification system.
  
  
  RESULTS
  Within a mean of 4.6 weeks, 7 ulcers healed completely and 4 improved markedly. The casting caused no complications. Moreover, extension deficits improved markedly in all patients (105 degrees +/- 27 degrees to 17 degrees +/- 10 degrees ).
  
  
  CONCLUSIONS
  Serial casting may be a valuable tool in the treatment of pressure ulcers at the extremities of patients with severe cerebral spasticity.
authors.affiliation: Department of Neurological Rehabilitation, Bavaria-Klinik, Kreischa, Germany. pohl@klinik-bavaria.de
authors.forename: Marcus
authors.initials: M
authors.lastname: Pohl
authors.forename: Stefan
authors.initials: S
authors.lastname: Rückriem
authors.forename: Herwig
authors.initials: H
authors.lastname: Strik
authors.forename: Bettina
authors.initials: B
authors.lastname: Hörtinger
authors.forename: Daniel
authors.initials: D
authors.lastname: Meissner
authors.forename: Jan
authors.initials: J
authors.lastname: Mehrholz
authors.forename: Max
authors.initials: M
authors.lastname: Pause
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000150:complications*; D002370:Casts, Surgical; D003286:Contracture / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000150:complications*; D003668:Pressure Ulcer / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome