Page 107 - Orthopedic Casts and Splints2

Performance Steps

14. Apply cast padding (webril) to patient's injured leg.
CAUTION: If the cast padding is wrinkled it must be removed and new padding applied. Wrinkled padding
can cause pressure sores which can lead to ulcers
a. Hold webril with one hand.
b. With 2nd hand unroll the webril 1/2 - 1 inch and grasp edge with index, middle finger and
thumb.
c. Place the edge of the webril at the distal aspect of the tibia/fibula and begin wrapping around
the malleolus two rotations.
NOTE: The technician may also start 1 inch from the distal edge of the stockinette.

NOTE: The webril application is started at the distal aspect of the tibia/fibula to provide an anchor and
extra padding to the malleolus.

CAUTION: Keep the cast padding on the extremity throughout the application to avoid circulation
compromise of the patient's toes.
d. Continue up the foot and leg, ending 3 inches distal to the fibula head.
CAUTION: The peroneal nerve is located on the lateral side of the leg. If the nerve is constricted it
could die and cause drop foot( known as nerve palsy ). This is an irreversible condition. Locate the fibula
notch/ head and measure 1 finger breath width below to prevent this condition.
e. With each turn overlap the webril by 1/2 -1/4 the previous wrap. The top of the webril should
bisect the middle of the previous layer covering up the shallow line and present evenly applied
padding. To reduce possible constrictive edema caused by applying webril too tight, keep the
webril on the extremity as it is applied.

15. Prepare casting materials.
a. If using plaster rolls, go to step 18
b. If using fiberglass rolls, go to step 16 and 17.

16. Place fiberglass casting gloves on hands.
CAUTION: To prevent chemical burns to the hands it is mandatory for the technician to use fiberglass
casting gloves .
17. Open fiberglass casting package and go to step 18 .
NOTE: Open one fiberglass package at a time. As fiberglass comes in contact with the air, the roll will
start to cure (set up ).

18. Apply 1st plaster/fiberglass roll.
NOTE: Examination gloves are recommended to protect the technician's hands as the resin in the plaster
may cause the skin on the hands to dry up.
a. Hold plaster/fiberglass roll with one hand.
b. With opposite hand unroll the plaster/fiberglass 1/2 -1 inch and grasp the edge with thumb,
index and middle fingers.
NOTE: Alternate method of placing the thumb under the forward edge of the roll can also be used.
c. Place plaster/fiberglass roll vertically in bucket of tepid water and remove when bubbles cease
to rise.
CAUTION: Removing the casting material when bubbles are present ensures dry spots will be visible
during application. Dry spots cause integrity break down of the cast.
d. Squeeze the roll together ( do not wring the roll ).
NOTE: To evenly distribute the water and prevent telescoping of the roll during application gently
squeeze the roll inward.

e. Place the edge of the casting material at the distal aspect of the tibia/fibula and begin
wrapping around the malleolus two rotations.
NOTE: The technician may also start 1 inch proximal to the edge of the webril.

104