Application of the Ambulatory Total Contact Cast (TCC)

[megagiant14]

I am looking into being an orthopedist but I have no clue what those terms he used mean I am only 12 but could you still explain the terms he used

[scottpop11]

take this is not a WB cast because there is no padding over the lateral side or over the heel

[lilrizeey]

Iv done about 20000 tcc myself .Theese guys make it look way harder than it is.

[333tommyboy333]

deffinately overdone... the way we do it is much simpler.

[kingortopedia]

@333tommyboy333 how do you do the TCC

[clearscpm]

Sam: We use a minimal amount of padding for the reasons you note.

[sam56n]

Thanks for the video Dr. Armstrong; as far as dressing the plantar ulcers, do you use the same amount of padding/dressing when using a TCC or you try to minimize it for the sake of a better/more even weight distribution,

Thanks,

Sam

[clearscpm]

Jay: Many thanks for the note. There are no doubt many modifications to the TCC. This one is a variant of the classical Carville cast. The only padding is over the tibia and malleoli to allow for a site for its removal. The distal padding is to prevent anything from getting in the cast as well as allowing protection from any pistoning distally. This technique has been used in at least three randomized trials to date.

Cheers, -DGA

[Blacksunshine636]

Thanks for the reply. I'll will have to look in to this.

Jay

[Blacksunshine636]

Since when did this style of cast become a "total contact cast". I used to do these about ten years ago and then a "Total Contact Cast" was plaster over stockinet, with very little padding. The plaster worked as an absorbant dressing.

How is this benificial over a regular short leg walking cast?

Thanks,

Jay

[lennic95]

psssst! what's this 4???

[lunuzi]

I have done ove 10,000 TCC in my career and everyone has their own technique, however, with my yechnique, it can be done alone with the patient in the seated position, controlling for equinus/varus/valgus in about 20 minutes. I respectfully disagree that the rubber "pivot" is essential to the mechanics of the cast, as the TCC can either serve as an anchor or a crutch LLD and I prefer the anchor design to control Amb/ADL. Use of cotton webril is essential for the conical shape and padding.

[DeeRay0814]

I know someone who is intrested in this area of healthcare. What exactly is your career title?

[lunuzi]

I have done ove 10,000 TCC in my career and everyone has their own technique, however, with my yechnique, it can be done alone with the patient in the seated position, controlling for equinus/varus/valgus in about 20 minutes. I respectfully disagree that the rubber "pivot" is essential to the mechanics of the cast, as the TCC can either serve as an anchor or a crutch LLD and I prefer the anchor design to control Amb/ADL. Use of cotton webril is essential for the conical shape and padding.