Page 92 - Orthopedic Casting Manual

2.2 Short Arm Cast LSAC) cont ...

Stockinette Applic ation
Applying stockinette and p adding cor rectly is crucial for p atient comfor t and protection when applying an
or thopedic shor t ar m fracture c ast. Here is a step-by-step guide on how to apply both the stockinette and
p adding:
Me asure the length: Me asure the p atient's ar m from the wr ist to just below the elbow, and then add a
few inches to ensure the stockinette covers the entire are a that will be immobilized by the c ast. The
ex tra length will also allow you to fold the stockinette over the c ast edges later.

Cut the stockinette: Cut the stockinette to the appropr iate length, taking c are to cre ate a cle an, even
edge.

Appl y the stockinette: Slide the stockinette onto the p atient's ar m, ensur ing it is smooth and wr inkle-
free. The stockinette should cover the entire are a that will be immobilized, ex tending from the wr ist to
just below the elbow. Le ave the ex tra length at both ends for folding over the c ast edges later. Refer to
cor responding video at the end of this lesson for detail instructions on appl ying the thumb "Gumby".

Padding Applic ation

Begin at the wr ist: Star t appl ying the p adding at the distal end of the ar m (the wr ist). This will provide
ex tra cushioning to the most vulnerable are as.

Wrap evenl y: Roll the p adding evenl y around the ar m, over lapping e ach layer by approximatel y 50% to
ensure even pressure distr ibution and adequate cushioning.

Cover bony prominences: Make sure to p ad bony prominences more generousl y, such as the wr ist and
the olecranon (the bony tip of the elbow). This helps to prevent pressure points, skin ir r itation, and
discomfor t.

Smooth out wr inkles: As you appl y the p adding, smooth out any wr inkles or folds to ensure a
comfor table f it and prevent pressure points.

Progress up the ar m: Continue wrapping the p adding up the ar m, maintaining even pressure and
coverage until just 3]4 f inger bre ad ths below the elbow. Ensure the p adding ex tends beyond the are a
that will be immobilized by the c ast. Continue b ack down the ar m over lapping half the previous layer
and incor porate the flattening the tire technique, per video instruction.

Secure the p adding: Once you re ach the desired level of p adding, tr im the p adding mater ial and
secure it in place by simpl y appl ying light pressure on top layer. Tape or tucking the end under the
previous layer is not necessar y.

By c arefully applying both the stockinette and p adding, you cre ate a comfor table and protective layer bet ween
the p atient's skin and the fiberglass c ast mater ial. This helps to minimize the r isk of skin ir r itation, pressure sores,
and other complic ations dur ing the he aling process.