Page 16 - Orthopedic Casts and Splints2

Performance Steps
NOTE: All hand casts are applied absent of pronation, supination, radial, or ulnar deviation unless
directed by physician.
a. Elbow measurement.
(1) Place the stationary arm of the goniometer parallel to the humerus.
(2) Place the moving arm of the goniometer vertically, bisecting the forearm and 2nd and
3rd MCPJ's.
(3) Place the protractor of the goniometer on the elbow.
(4) Set elbow until the goniometer measures 90 degrees of flexion.
b. Wrist measurement.
(1) Place the stationary arm of the goniometer vertically, bisecting the 5th phalange ( pinky
finger)
(2) Place the moving arm of the goniometer vertically, bisecting the ulnar .
(3) Place the protractor of the goniometer on the ulnar styloid.
(4) Set the wrist until the goniometer measures between 0-15 degrees of dorsal extension.

15. Apply cast padding(webril) to injured arm.
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 and middle finger .
c. Place the edge of the webril on the ulnar styloid and begin wrapping around the wrist two
rotations.
NOTE: The webril application is started at the wrist to provide an anchor and extra padding to the ulnar
styloid.

CAUTION: Keep the cast padding on the extremity throughout the application to avoid circulation
compromise of the patient's hand/fingers.
d. Continue through the palm ending 1/2 inch distal to the stockinette edge , back up the
forearm, figure of eight around the elbow, ending 1/2 inch proximal to the stockinette edge .
e. 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.

NOTE: The cast padding can be cut or torn (horizontally ) when wrapping through the palm
and elbow to provide a better fit. The technician preference will determine which technique to
use.

16. Prepare casting materials.
a. If using fiberglass casting material, go to step number 17.
b. If using plaster casting material, go to step number 19 and omit step 17 and 18.
17. Place fiberglass casting gloves on hands.
CAUTION: The use of fiberglass casting gloves are mandatory to prevent the technician from receiving
chemical burns while using fiberglass casting materials.

18. Open fiberglass casting package and go to step 19.
NOTE: Open one fiberglass package at a time. As fiberglass roll comes in contact with the air, the roll
will start to cure and harden.

19. 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 or fiberglass roll with one hand.
b. With opposite hand unroll the plaster/ fiberglass roll 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.

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