In the last issue of Body Cast, Rounds asked: 'What is topographical anticipation?

The following responses were received:

From Adrian Corpsman:

Topographical anticipation is the process of mapping out the procedure you are about to perform in anticipation of what the end result should become.

From Ed Hayes:

An anatomical description of a body part (i.e... lower leg) , in terms of the region it is located in. The body structure and all of the systems of that body part and their relationships to it

I anticipate that this is close to being correct!

From Cheryl Rivers:

Topography is mapping: it is a description of a special region in our body, especially of the mutual relationships of ad jacent structures. According to research, these organs are expected to be at a certain area.

From Tom Yorke:

Topographical = topographic-of or pertaining to topography. description of a place

Anticipation = the act of anticipating, taking up. placing.. or considering something before hand, or before the proper time in natural order

This topic can be thought of in different ways for different situations. As pertaining to cast work, it can be what the orthopaedic technologist is thinking as he applies a cast. thinking ahead as to swelling, position, healing, to what the cast will be molded to the affected limb. To the patient after looking at x-rays first in the emergency department to what the affected limb will look like after intervention from a clinic perspective, i.e.., casting surgery.

From a physician's perspective, it can be what the affected limb will look like following a procedure of casting or surgery whether it is to fix an exciting limb with or without prosthetics. The patient also worries about the affected limb after intervention by a surgeon. This also can be felt by family members taking care of the patient whether they are young or old.

From the editor, Mardy McPolin:

Although many found the question difficult, kudos to those who sent a response. I posed the question of topographical anticipation to the ortho guys and they loved the term and understood it when they thought about it for a moment. Dr. Catre said that it is in our subconscious, used in our daily practice. It has nothing to do with Freud and signal anxiety or EMG studies of pain responses. I did not make this term up - it is from a published text on hand injuries and infections by Dr. Michael A. Kohn.

As orthopaedic technologists, we, through osmosis, have learned a great deal without truly recognizing it. When we apply a cast, we examine a limb, we recognize a bony prominence and pad it appropriately. When we see a soft tissue injury, we know more is going on than we see on an x-ray. We look after a wound accordingly and, perhaps, cut a window in the cast for dressings. We continually do many things instinctively in the course of our daily duties, far too many to detail here. I agree, it is not a common term, but it is so very common in our routines as techs. Sure the question was not easily found on Google or other search engines (what did we do before computers?) like all the other questions. Should the Rounds questions not cause you to stop and think just a little? Should Rounds questions only ask what you know?

Responses were also received from: E. Clancey, C. Griffith, S. Groulx, L. Head, M. Lash, B. Lavallee, N. Lockyer, C. Longphee, D. Longphee, G. Marshall, J. Maulucci, J. Movasseli, E. Oborowsky, T Ogden, J. Pike, V Robichaud, B. Sheppard, V Stockdale, A. Tarambikos and H. Wong.