Many failures in conservative treatment can be traced to inadequate plaster technique. A good manipulative reduction is often allowed to slip during the clumsy application of plaster. The surgeon who aspires to skill in the conservative method must subject himself to a long apprenticeship in ‘plastercraft.’ Skill is not to be learned from books but only by continuous repetition for at least one year, and the casualty officer who regards the application of plasters as a menial task to be delegated to juniors or to the nursing staff will be well advised to transfer his attention to another specialty. Until the surgeon's hands have acquired an automatic rhythm, being able to pass and mould the turns of bandages quickly, regularly, and subconsciously, his mind is not free to devote its entire concentration to the tissues of the fracture.

PADDED AND UNPADDED PLASTERS

Plaster casts can be divided into three types: (i) ‘badly padded’ plaster, (2) unpadded plaster, and (3) padded plaster.

‘Badly Padded’ Plaster

It was against the background of the badly padded plaster that Böhler inveighed with such effect, and it was Böhler's teaching which established the use of the unpadded plaster, applied directly to the skin without any soft material intervening. So powerful were his convictions that even now the word padding is still regarded in many circles as something unmentionable or as something for which to apologise.