Page 117 - Orthopedic Casts and Splints2

Performance Steps
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 or fiberglass roll with one hand.
b. With opposite hand unroll the plaster/fiberglass 1/2 -1 inch and grasp edge with thumb, index
and middle fingers.
NOTE: Placing the thumb under the forward edge of the roll can also be used.
c. Place the plaster or fiberglass roll in bucket of tepid water and remove when bubbles cease
to exist.
CAUTION: Removing the casting material when bubbles are present ensures dry spots will be visible
during application. Dry spots can 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 plaster or fiberglass roll 1/2 inch distal to the edge of the webril and
begin wrapping around the wrist two rotations to secure the edge.
f. Continue back up the forearm, figure eight around the elbow, ending 1/2 inch proximal to the
edge of the webril
g. Overlap the plaster/fiberglass by 1/2/ or 1/4 the previous wrap. The top of the
plaster/fiberglass should bisect the middle of the previous layer and present an evenly
applied cast.
18. Laminate the casting materials.
a. Place palm of each hand on the cast.
CAUTION: To reduce cast indentations, which can cause pressure sore to the patient's skin under the
cast, keep finger tips off the cast during application and molding process. If the patient feels pressure
or hot spots developing under the cast, the cast must be removed immediately.
b. Rub the cast material in the direction it was applied.
NOTE: Laminating the cast material fills in the pores which assist in providing strength to the cast.
c. Continue rubbing the cast until the tone/texture changes from a glossy/creamy color to a dull
white color.
NOTE: The dull white color indicates the casting material is curing.

19. Apply posterior reinforcement splint.
NOTE: Plaster reinforcement splint is used to strengthen and support the cast.
a. Place the plaster splint in bucket of tepid water, wait for bubbles to subside and remove
splint from water.
b. Squeeze the splint together to eliminate excess water.
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.
d. Place reinforcement splint on the posterior side of the elbow extending from the axilla region
to mid forearm .
e. Smooth out splint and continue to laminate.
f. Maintain patient's elbow at 90 degrees of flexion.
20. Apply 2nd plaster/fiberglass roll( repeat steps 18-19 ).

21. Measure injured elbow with goniometer.
a. Place the stationary arm of the goniometer horizontally, bisecting the middle of the humerus
and deltoid muscle.
b. Place the moving arm of the goniometer vertically, bisecting the middle of the forearm and
the 2nd and 3rd phalanges.
c. Place the protractor of the goniometer on the olecranon( elbow).
d. The goniometer should measure 90 degrees of flexion.
NOTE: If elbow is not measured at 90 degrees of flexion, the forearm is in pronation or supination,
remove the cast and go to step 8.

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