Page 109 - Orthopedic Casts and Splints2

Performance Steps
c. Place the protractor of the goniometer on the lateral malleolus.
d. The goniometer should measure 90 degrees of dorsiflexion.
NOTE: If the malleolus is not at 90 degrees of dorsiflexion, everted or inverted remove cast and go to
step 13.
25. Position the patient's injured leg to extend cast.
NOTE: Family members, nursing staff, thigh stand, or orthopaedic bump can be used to assist in
maintaining the proper flexion of the patient's knee.

NOTE: If no assistance is available, do not begin the upper portion of the cast until the heel of the cast
has dried.
a. Place the stationary arm of the goniometer horizontally , bisecting the lateral aspect of the
femur.
b. Place the moving arm of the goniometer horizontally , bisecting the lateral aspect of the fibula.
c. Place the protractor of the goniometer on the lateral aspect of the knee.
d. Set knee until the goniometer measures between 0-15 degrees of flexion.
CAUTION: The patient will not be able to maintain this position. The technician may used an assistant or
other supports.

26. Apply webril to patient's injured leg.
a. Hold webril roll with one hand.
b. With 2nd hand unroll webril 1/2 -1 inch and grasp edge with index and middle finger .
c. Place edge of the webril at the proximal edge of the previous applied webril.
NOTE: There must be webril to webril contact to facilitate an evenly applied cast and to reduce cast
complications.
d. Continue around the knee in a figure of eight wrap and up the leg.
e. Angle the webril roll and continue pass the greater trochanter ending 1/2 inch distal to the
medial and lateral stockinette edge.
NOTE: The webril can be cut or torn to redirect the roll at an angle
f. 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 shadow 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.
NOTE: If webril is wrinkled , shadow lines exist, or knee is not between 0-15 degrees of flexion, remove
webril, reposition knee and return to step

27. Apply 3rd plaster roll.
a. Place casting material on the distal portion of the SLC and begin wrapping around the knee.
b. Continue around the knee in a figure eight wrap and up the leg and ending 1/2 inch from the
cast padding.
c. Angle the cast material and continue pass the greater trochanter ending 1/2 inch distal to the
medial and lateral webril edge.
NOTE: The cast material can be fan folded to encompass the greater trochanter.
d. With each turn overlap the plaster/fiberglass by 1/2 -1/4 the previous wrap. The top of the
plaster/fiberglass should bisect the middle of the previous layer and present an evenly applied
application.
NOTE: To reduce possible constrictive edema caused by applying plaster/fiberglass too tight, keep the
casting materials on the extremity as it is applied.
28. Apply plaster reinforcement splint .
NOTE: Plaster reinforcement splint is used to strength and support the cast.
a. Place splint in bucket of tepid water, wait for bubbles to subside and remove splint from water.
b. Squeeze the plaster splint together.
c. Extend plaster splint and squeegee out excess water.
NOTE: Place index and middle fingers on either side of the splint and move fingers down the splint.

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