Hands on Education: Creating a Univalve Night Cast without use of a Cast Saw for Ankle Range of Motion Management

This hands-on and interactive course will teach attendees a new strategy for creating ankle casts that are light, flexible, and do not require the use of a cast saw for removal. Serial casting is the most effective method of gaining ankle range of motion in children with idiopathic toe walking and cerebral palsy. At the completion of serial casting, orthoses or bivalve casts are often used at night to maintain newly gained range. In our facility, a bivalve night cast was typically the intervention of choice. Serial casting was completed using a hybrid technique of soft and fiberglass material allowing for removal at home as learned through an Amanda Hall casting course. This hybrid technique was not used for night casting because once removed, it does not hold its shape. Therefore, bivalve night casts were created using fiberglass casting tape. A bivalved cast is heavy and requires cast saw removal. Cast saws can cause stress and medical trauma for pediatric patients. Building on saw-free hybrid casting techniques, we developed a univalved cast that can be applied like an AFO and secured with Velcro for use at night or during the day for individuals unable to tolerate traditional serial casting. This technique is considerably faster and more user friendly than a fiberglass bivalve. Participants will leave the course able to identify appropriate patients and immediately use the univalve technique with their patients. Through hands-on practice, demonstration, and discussions, participants will apply and remove a univalve splint using other participants as models.