Page 126 - Orthopedic Casts and Splints2

Performance Steps
CAUTION: To prevent chemical burns to the hands it is mandatory for the technician to use fiberglass
casting gloves .
14. Open fiberglass casting package and go to step 15 .
NOTE: Open one fiberglass package at a time. As fiberglass comes in contact with the air, the roll will
start to cure (set up ).

15. 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: Placing the thumb under the forward edge of the roll can also be used.
c. Place plaster/fiberglass roll 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 1/2 inch distal to the webril and begin wrapping
above the malleolus two rotations.
f. Wrap a figure of eight around the knee.
NOTE: The cast medial edge is 4 inches distal to the groin, with the cast lateral edge 2 inches
proximal to the greater trochanter.
g. Continue wrapping the casting material up the leg.
NOTE: The cast material can be fan folded to obtain a distance of 4 inches distal to the groin and 2
inches proximal to the greater trochanter.
h. Place the roll diagonally to the cast and continue wrapping the cast material ending 1/2 inch
from the proximal edge of the webril.
NOTE: Patient positioning may need to be adjusted. Assistance is authorized.
i. With each turn overlap the plaster/fiberglass by 1/4 -1/2 the previous wrap. The top of the
plaster/fiberglass should bisect the middle of the previous layer and present evenly applied
casting material. To reduce possible constrictive edema caused by applying the
plaster/fiberglass too tight, keep the plaster/fiberglass roll on the extremity as it is applied.

16. 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 assist it providing strength to the cast.
c. Continue rubbing the plaster cast until the tone/texture changes from a glossy/creamy color
to a dull white color. If using fiberglass continue to laminate until the cast begins to cure.

17. Apply reinforcement splints to knee.
NOTE: Plaster reinforcement splint is used to strength and support the cast.
a. Place the splint in tepid water, wait for bubbles to subside and remove splint from water..
b. Squeeze the splint together to eliminate excess water.
c. Place 1st reinforcement splint ( figure of eight) at the proximal edge of the cast on the lateral
side crossing over the knee and resting on the gastrocnemius muscle.
NOTE: The splint can also be placed on the medial or lateral sides of the cast.
d. Place 2nd reinforcement splint at the proximal edge of the cast the medial side crossing
over the knee and resting on the gastrocnemius muscle.
e. Laminate the splint to the cast.

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