Serial Casting and Paraffin

The application of a serial cast is a common intervention for static-progressive mobilization of resistant PIP joint contractures. However, This technique can be troublesome for many patients due to skin issues over the dorsum of the PIP joint or the compliance issues related to casting. One technique that I have employed is the application of the cast over a digit that has been dipped in  paraffin.

The finger is dipped in paraffin 3 times to allow a small build up of wax over the finger. The serial cast is then applied over the paraffin in standard fashion with cylindrical wrapping. The finger is held in the corrected position until the plaster is set. The cast can now be slid off for bathing and skin checks. It will readily slip back into place upon completion of hygiene activiy. This technique works best with contractures of 30 degrees or less.

Submitted by Paul Bonzani OTR/CHT