Outcome between plaster cast and fiberglass cast in stable thoracolumbar burst fracture

Abstract

Objective: This study was designed to evaluate the functional and radiological outcome of patient with thoracolumbar burst fracture treated conservatively with body cast between plaster of Paris cast and fiberglass cast. Methods: Forty cases of stable thoracolumbar burst fracture were treated conservatively in orthopedic ward Hospital Sultanah Aminah Johor Bahru and Hospital Tengku Ampuan Afzan from January 2013 till December 2015. 40 patients were followed-up with minimum period of 1 year and evaluated for the functional (Oswetry disbility index) and radiological (kyphotic angle deformity and anterior body compression) outcomes by a series of questionnaire and measurement. Result: there were 40 patients received conservative treatment with body cast for stable thoracolumbar burst fracture. 20 patients treated with body cast made form plaster of paris and remaining 20 patients with fiberglass cast. There were 26 male and 14 female with mean age 40.1 years old. Racial distribution showed Malay population 65%, Chinese 22%, Indian 10% and others 3%. All patients had bony union within three months after application of body cast. In plaster of paris group, mean kyphotic angle deformity at last follow up was 16.60 ± 2.95 with a mean improvement 4.45 degree and anterior body compression at last follow up was 30.35% ± 10.2 with mean improvement of 9.30%. In fiberglass group, mean kyphotic angle deformity at last follow up was 15.55 ± 3.38 with a mean improvement 7.25 degree and anterior body compression at last follow up was 25.90% ± 7.81 with mean improvement of 3.45%. The functional outcome showed Oswetry Disability Index (ODI) score in plaster of paris group was 23.70 (SD = 7.82) and in fiberglass group was 18.50 (SD = 5.94). Conclusion: application of body cast using a fiberglass material give better radiological outcome hence less pain, more functional and higher patient’s satisfaction as compared to plaster of paris.