AN OPEN-shoulder spica has provided a satisfactory means of managing several conditions previously requiring the traditional full spica (Fig 1). A combination of a waistband and a long arm cast connected with a wooden and plaster outrigger was first applied to an adult patient who was unwilling to remain in the traditional spica following a shoulder fusion. He had torn his plaster down in order to maintain his skin hygiene and to gain comfort. The open-shoulder spica was designed as a compromise, but it maintained the desired position until union was achieved. This spica cast has since been satisfactorily used to maintain the desired position in patients undergoing shoulder fusion, derotational humeral osteotomy, soft-tissue release with tendon transfer around the shoulder (L'Episcopo-Zachary procedure), and following reconstruction of a posterior dislocation of the shoulder.
An open-shoulder spica has the following advantages: (1) simple application, (2) easy and accurate positioning, (3) light