An eight-year-old child begins a trial of serial casting. Which clinical finding would BEST support the use of this type of intervention?

• A. Delayed bone healing
• B. Limited range of motion
• C. Insufficient muscle strength
• D. Inadequate bone density

Answer: (B)

Serial casting targets a joint with a contracture by gradually lengthening the surrounding soft tissues to increase range of motion. When a child’s joint motion is limited because of a fixed or progressive contracture, a sequence of casts that slowly reposition the limb allows tissues to lengthen and adapt over time, improving motion and function. That’s why a limited range of motion best supports using this method. Delayed bone healing, insufficient muscle strength, or inadequate bone density point to other concerns—bone pathology, weakness, or bone health risks—that would lead to different treatment considerations rather than serial casting.