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When your child's joint is unable to extend or flex, one of the connected muscles may be too tight or too short. To assist in turning the joint in the correct direction, our orthopedic specialists may recommend serial casting.

The term "serial" is used because each cast is one in a series that will progressively stretch the muscle or joint a bit further each time.

The technique is primarily used on knees, ankles and wrists, and can help children with an array of conditions, including:

The average serial casting round is approximately four to six weeks, and depends on how much the muscle needs to expand.

Specific treatments and services may vary by location. Please contact a specific location for more information.

About Your Cast

Removal and care of a cast in this series is similar to a cast your child would receive for any other reason.

Caring for Your Cast

  • Do not get the cast wet
  • Do not put foreign objects inside the cast. For example, avoid using a hanger or ruler to reach an itch. Instead, tap on the outside of the cast or use the cool setting of a hair dryer to blow soothing air down the cast.
  • Follow your care provider's instructions regarding use of the casted arm or leg

Cast Removal

  • A cast saw will be used to remove the cast each time
  • Your child’s leg or arm will be measured to see how much motion has been gained
  • A new cast will be applied, gently increasing the stretch further
  • The process will repeat until the best results are achieved
Serial stretch casting can be a great method to bridge the gap between regular conservative treatments and surgical intervention. It can be highly effective, especially in younger children, and may help delay or avoid surgery.
Lauren Hyer, M.D., Shriners Children's Greenville

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Next Steps

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Families and caregivers seeking treatment should start by contacting us for an appointment.

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Physicians and healthcare providers can request appointments, start transfers or contact us with questions.