Hyperextension cast or hyperextension body cast is applied with patient’s vertebral column in position of hyperextension. Hyperextension cast extends from symphysis pubis to suprasternal notch in the front and from tip of coccyx to scapulae behind. This is done so as to prevent even smallest degree of forward flexion of the spine.
Hyperextension has more of historical value than any active therapeutic. In the past it was used to treat compression fractures of the spine or in some cases surgery of the spine.
In modren medical treatment, hyperextension cast has very limited usefulness.
How to Apply Hyperextension Cast?
The hyperextension cast was usually used in non operative treatment of some compression and stable burst fractures. It is performed via following steps
1. The patient is placed on a modified fracture table as shown in the figure. All the standard measures should be folowed while shifting a fracture spine patient.
2. The patient is suspended on a narrow, midline, taut canvas support. The arms should be to the side, knees flexed, and feet resting on the support to give the patient a sense of balance.
3. Hyperextension is schieved at the fracture site by applying a vertically directed force that will achieve.
4. Once maximum hyperextension is achieved, relax the horizontal canvas support and place additional traction on the iliac crests.
5. After satisfactorily positioning the patient on the table, wrap the torso with soft padding
6. Pad the bony prominences additionally with foam and apply the cast.
7. Make a large anterior abdominal hole.
Following image shows the posterior extent.
Check radiographs should be obtained and reduction should be checked for.
Patient can be allowed to ambulate if satisfactory alignment has been achieved.
Following video does not demonstarte step by step application of hyperextension cast but gives a good idea about the procedure.
The video also shows patient ambulating after the cast.
Image Credit Chapman’s operative orthopaedics, 2nd ed. Philadelphia: JB Lippincott Co., 2001
Text adapted from Chapman’s operative orthopaedics, 2nd ed. Philadelphia: JB Lippincott Co., 2001
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