The trend we described five years ago has stabilised. The classic plaster cast has maintained its use as an initial immobilisation bandage in the short time leading up to an operation or until swelling has subsided. This is due to its price and ease of use. After this, fractures are often treated surgically and then stabilised with prefabricated orthoses. With this option mobility is regained more quickly.
If conservative treatment is continued after the initial cast, synthetic casts are preferred as they are lighter, more stable and water-resistant than plaster. But the previously used material made of fibreglass or polyester has been criticised because it is not environmentally friendly when it comes to disposal. Sustainable alternatives using bio-based polymers have recently been developed. These have a new property: They are processed in a warm state and harden when they cool down, but they can be reworked by heating them up again.
What seemed promising ten years ago has not materialised: Hard bandages do not come from the 3D printer. Only splints or simple orthoses are produced in this way. The process has become neither so simple nor so fast that it has found its way into medical practices. 3D printing remains the domain of specialised orthopaedic technology companies. Orthoses customised to the patient's anatomy are only produced when prefabricated products no longer meet the requirements.
What development options are still available? What does the future hold for immobilising bandages? Innovative casts could stimulate bone growth at the fracture site with inbuilt ultrasound transmitters. Studies have already shown that low-energy, pulsed ultrasound can significantly improve the healing rate of fractures. Such bandages could also be equipped with sensors that monitor the healing process and determine exactly how much ultrasound or other influences are needed. This would optimise the wearing time until mobilisation is possible again. In addition, new types of bandages could be coated with drugs that are released in a controlled manner to relieve pain and promote healing. This would improve the effectiveness of the treatment and shorten the recovery time. Such high-tech plaster casts would go far beyond simply immobilising limbs.
