I<$c$>n spite of all the technological advances we are still breaking our bones. I broke my ankle when I was 13 and wore a cast up to my knee for at least six weeks. This was the only way to have the bone heal. At first I thought it was great. Everyone could write on the plaster of Paris but when that was done, there was nothing great left about it. My underarms were sore from the crutches I dreaded using. I don’t see those casts anymore and someone told me they don’t exist. That something called air casts are used instead. I have seen them quite a bit — those large grey plastic very comfortable looking casts.

But my investigation into their use revealed that the plaster casts are by no means a thing of the past.

“When I first started everything went into a cast,” said Christine Grant, the staff nurse in the orthopaedic department at King Edward VII Memorial Hospital (KEMH). With 18 years in the emergency department and 15 in the fracture clinic, Ms Grant has seen thousands of Bermuda’s broken bones.

She said that in today’s modern orthopaedics a lot of splints or orthopaedic appliances are used instead of plaster. “But we still have to use plaster of Paris on a bad break,” she said. “There is still very much a place for it in the operating room and in children’s orthopaedics.”

“In the US they tend to use fibreglass instead of plaster,” she said. At KEMH they’ve found it best to use a layer of plaster, then reinforce it with fibreglass. “The fibreglass we use comes premixed,” she said “It is special it’s not like the fibreglass you use to fix your boat or car. In this case water actually speeds the process.”

And the fibreglass used to reinforce plaster casts at KEMH, has holes in it that allow the skin to breathe a bit.

Ms Grant said she finds working with plaster easier to mould than fibreglass. This means she is able to provide a more fitted structure for the broken bone. Fibreglass is more durable than plaster and provides a layer of waterproofing. It does not provide enough protection to allow patients to swim, shower or bath. But it does mean fewer visits to the hospital to have the cast repaired or re-done.

In the case of small breaks, breaks in small bones and sprains, the tendency now is to fit the patient with an air cast. Ms Grant said these casts are also used in patients who have been in a plaster/fibreglass cast and need to gradually build up strength for walking.

“It gives them support until the bones and muscles are strong enough,” she said.