The use of tone-reducing casts to prevent joint contractures following severe closed head injury

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Abstract
The management of patients with concomitant multiple trauma and closed head injury requires specific principles for the treatment of musculoskeletal injuries. Spasticity and agitation complicate closed treatment of fractures, and operative stabilization of fractures is often indicated. Spasticity, impaired cognition, and absence of sensation may prohibit circular cast treatment of extremity injuries in patients with closed head injury. This article presents a case report of a complication following circular cast management to prevent joint contracture in a patient with closed head injury. Circular cast management to prevent joint contractures in patients with closed head injury should be used with extreme caution, especially with concomitant extremity trauma.

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