Page 17 - Orthopedic Casts and Splints2

Performance Steps
c. Place the plaster or fiberglass roll in bucket of tepid water and remove when bubbles cease
to rise.
CAUTION: Removing the casting material when bubbles are present promotes dry spots during
application. Dry spots may cause integrity break down of the cast.
d. Squeeze the roll together(do not wring the roll).
e. Place edge of the plaster or fiberglass roll on the ulnar styloid and begin wrapping around
the wrist two rotations to secure the edge.
NOTE: The cast is most susceptible to losing strength in the palm region. Therefore, a twisting or
cutting method is authorized.

The Twisting method: As the roll is pushed through the palm pinch the sides of the plaster roll
together (not recommended for fiberglass) twist and evenly space the casting material on the webril.
Smooth out with volar side of fingers. The twisting method provides strength to the cast .

The CUT method: As the roll is pushed through the palm make a horizontal cut to the proximal edge
of the plaster/fiberglass roll and smooth out with volar aspect of fingers or palm.The cutting method
provides cast cosmetics. Each technician may have their own preference to the above methods.
f. Continue through the palm ending 1/2 inch distal to the edge of the webril, back up the
forearm, figure of eight around the elbow, ending 1/2 inch from the proximal edge of the
webril.
g. Overlap the plaster/fiberglass roll 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.

20. 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
sore 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 it 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.
21. Apply reinforcement splint to volar aspect of cast.
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 reinforcement splint on the volar side of the cast in line with the DPC and the outer
boarder of the thenar muscle and laminate
d. Maintain patient's wrist between 0-15 degrees of dorsal extension.
Note: Place patient's thumb and index finger in opposition to one another.
22. Apply reinforcement splint to posterior aspect of 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. Apply reinforcement splint to posterior aspect of the arm beginning 1/2 inch distal to the
edge of the cast to mid forearm.
d. Maintain patient's elbow at 90 degrees of flexion.

23. Apply 2nd plaster/fiberglass roll( repeat steps 19-20 ).
24. Mold the cast material to the forearm/wrist.
NOTE: The interosseous mold is used to prevent movement of the injured wrist in the cast and promote
fracture healing.
a. Place the heel of one hand on the volar aspect of the distal wrist.

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