Page 127 - Orthopedic Casts and Splints2

Performance Steps

18. Apply 2nd plaster/fiberglass roll ( repeat steps 15-16 ).
19. Mold casting material to leg.
a. The femoral mold
(1) Place the lateral aspect of the thumbs above the femoral head apply pressure. Hold
until contours take shape.
b. The tibia mold(triangle mold)
(1) Place lateral aspect of the thumbs on either side of the tibia, apply pressure and follow
the contour of the tibia proximal and distal.
c. The gastrocnemius mold(flat mold).
(1) Place the palm of your hand on the gastrocnemius and follow the contour of the muscle.
d. The soleus mold.
(1) Place the heels of the hand on each side of the soleus and apply pressure.
e. The quadriceps muscle and greater trochanter molds.
(1) Place the palm of one hand on the lateral side of the quadriceps muscle.
(2) Place the palm of opposite hand on the medial side of the quadriceps muscle and apply
pressure. Hold until contours take shape.
(3) Place the palm of one hand on the anterior side of the quadriceps muscle.
(4) Place the palm of one hand on the posterior side of the quadriceps muscle.
(5) Place the palm of one hand on the lateral side of the greater trochanter, and conform
the plaster.
NOTE: All molds are ongoing and may take several minutes. Continue to laminate and mold until cast
is cured.
20. Check range of motion ( ROM ) of ankle and phalanges.
a. Have patient extend and flex ankle.
b. Have patient extend, flex toes.
21. Measure injured knee with goniometer.
a. Place the stationary arm of the goniometer horizontally, bisecting the middle 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. The knee should measure between 0-15 degrees of flexion.
NOTE: If knee is not at 0-15 degrees of flexion ( or physician's order ), remove cast and go to step 10.

22. Apply 3 rd, 4th plaster/fiberglass roll ( repeat steps 17-18 )
23. Check cast dimensions.
a. Pull down the stockinette.
b. Have patient flex and extend ankle.
c. Trim as necessary.
d. Tape down edges of stockinette.
24. Apply 5th roll of plaster/fiberglass ( repeat steps 15-16).
NOTE: The last roll in all casting applications is commonly referred to as the beautification roll or the
money roll. Take pride in your work.

25. Check patient's capillary refill.
a. Squeeze patient's toes and nail beds will turn white .
b. Release patient's toes and nail beds will return pink .
CAUTION: If capillary refill is delayed for more than 2 seconds inform physician and follow physician's
instruction.

26. Clean plaster resin off patient's skin using a damp wash cloth, towel or alcohol pad.
NOTE:Use alcohol pads or fresh water from the faucet and not from the casting bucket.

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