Page 125 - Orthopedic Casts and Splints2

Performance Steps
NOTE: If patient is unable to answer, ask family member. If family member is not present use a
substitute application(e.g. mastisol).
b. If no known allergies exists apply tincture of benzoin on the medial/lateral aspect of the
injured leg beginning four inches distal to the groin and ending one inch above the
malleolus(ankle)
c. If known allergies exists apply mastisol as in step 9 b.
10. Measure patient's injured knee w/ goniometer.
NOTE: All LLCC are applied with knee between 0-15 degrees of flexion, unless otherwise indicated by
physician's order.
a. Position the patient's injured knee between 0- 15 degrees of flexion.
NOTE: There are several ways to obtain 0-15 degrees of flexion. The patient could maintain the
position, nursing personnel or family member can assist, a thigh stand or orthopaedic bump could also
be used. It is the technician preference.
b. Place the stationary arm of the goniometer parallel to the fibula.
c. Place the moving arm of the goniometer in line with the lateral edge of the femur.
d. Place the protractor of the goniometer on the lateral aspect of the knee.
e. Set the knee until the goniometer measures between 0-15 degrees flexion.

11. Apply cast padding (webril).
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 proximal to the tibia/fibula and begin wrapping around the above
malleolus two rotations.
NOTE: The webril application is started 2 inches proximal of the tibia/fibula (ankle) 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 foot.

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 apply extra padding.
d. Continue wrapping the padding up the leg.
e. Wrap a figure of eight around the knee and continue past the greater trochanter.
f. Hold the padding diagonal to the thigh and wrap 4 inches distal to the groin and end 3
inches proximal to the greater trochanter.
NOTE: The cast padding can be ripped or layered to insure the greater trochanter is covered.
g. 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.
NOTE: Extra padding in the form of felt, or adhesive padding can be place 1 inch proximal to the ankle
and groin area for extra protection.
12. Prepare casting materials.
a. If using plaster rolls, go to step 15 .
NOTE: The technician may need to use more than one roll per application. If more than one roll is
needed , the technician should start where the last roll ended.
b. If using fiberglass rolls, go to step 13 and 14 .
13. Place fiberglass casting gloves on hands.

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