The first record showing splints and immobilization devices dates back to approximately 3,000-2,500 BC in Egypt ¹.  Archeologists and others exploring the Egyptian tombs noted sticks and other material surrounding the mummified bodies.  These primitive devices were the first known splints and casts.  Edwin Smith’s research, published in 1908, states multiple cases of splints applied to fractures to reduce movement ^{2 3}.  In fact, the pictures on this page are of the casts.  The splinting material used was dependent upon the location of the fracture.  The femur is shown being stabilized with cut wood planks and cloth.  The ulna radius is stabilized by tree bark with an outer linen cloth to hold the bark ³.

Over the millennia, little changed in the design of the cast.  Hippocrates (approximately 400BC) used multiple layers of bandages hardened by wax and other materials.  Celsus (Roman physician around the BC/AD transition) hardened the cast using starch.  It wasn’t until nearly 1,000 AD, that plaster was used. Avicenna, a surgeon in present day Baghdad, Iraq, soaked bandages in calcium oxide (lime) and egg white albumin to form a plaster.  The method was used throughout Europe, until 1798 when plaster of Paris was discovered and introduced as a possible material.  When exposed to water, calcium sulfate hardens.  The calcium sulfate solid material was mined near Paris, and thus received the name “plaster of Paris.”

Antonius Mathijsen (Dutch surgeon – 1851) is credited with developing the plaster of Paris casts used today, and his work was published in 1852 – that’s 167 years ago!  The cast materials included layers of linen bandages with dry plaster placed between.  Once water was applied, the bandages would harden and form a rigid cast.  The method has not changed much since.  In the 1970s, fiberglass was incorporated into a bandage form, and when mixed with water hardens.  Nearly 50 years ago, this process was designed as a cast and has not changed ¹.

Exosseus strives to modernize archaic casting techniques with an overall more superior product.  3D printed plastics will replace fiberglass and plaster of Paris, while bringing a modern fusion to immobilization devices.

Picture 1: Ulna and radius compound fracture of an Egyptian Mummy with bark as a support material.

Picture 2: Femur fracture of an Egyptian mummy with splint attached.

Picture 3:  Exposed compound femur fracture of Egyptian mummy with splint material removed.

Citation:

Pictures:

1. Smith, GE MD.   The Most Ancient Splints.  BMJ.  732-736.  Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2436247/pdf/brmedj07954-0008.pdf

Text:

1. Demaio M MD, McHale K MD, Lenhart M MD, et. al.   Plaster: Our Orthopaedic Heritage.  AAOS.  94e152:1-8.  Available from: https://www.ncbi.nlm.nih.gov/pubmed/23079886
2. Blomstedt P.   Orthopedic Surgery in Ancient Egypt.  Acta Orthopaedica.  85(6):670-676.  Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4259025/pdf/ORT-85-670.pdf

3. Smith, GE MD.  1908.  The Most Ancient Splints.  BMJ.  732-736.  Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2436247/pdf/brmedj07954-0008.pdf