Page 201 - Orthopedic Casts and Splints2

Performance Steps
NOTE: 15-20 plaster sheets are needed for all lower extremity splints.

NOTE: 5 x 30 inch plaster splints are usually stacked in increments of five from the manufacturer. If
not pre stacked, count out in groups of five, 20-30 layers of plaster sheets.

NOTE: The technician may choose to use 6 inch plaster rolls.
b. Place 3 stack of sheets on each padding, cut excess as needed.
NOTE: The sheets should be centered on the padding leaving a 1/2 inch edge on all sides.
10. Measure patient's injured ankle w/ goniometer.
a. Position the patient's injured ankle at a 90 degree angle to the tibia.
NOTE: There are several ways to maintain the ankle at a 90 degree angle. The patient could maintain
the ankle position, nursing personnel or family member may assist, a thigh holder may be used, or
place the patient in the prone position. It is the technician preference.
b. Place the stationary arm of the goniometer parallel to the tibia.
c. Place the moving arm of the goniometer in line with the lateral edge of the heel and the head
of the fifth metatarsal(little toe).
d. Place the protractor of the goniometer on the lateral malleolus.
e. Set the ankle until the goniometer measures 90 degrees of dorsiflexion.
NOTE: To assist the patient in maintaining a 90 degree angle, have the patient bend the knee and
point toes upward or simulate squashing a bug with the heel of their foot. This will assist in maintaining
the ankle at a 90 degree angle.

NOTE: The technician may use their own style to assist patient.

11. Apply posterior splint (L) to injured leg.
a. Place thigh holder under patient's injured leg (hamstring region )
CAUTION: Depending on the orthopaedic device used, the circulation to the toes and foot may be
constricted. Always communicate with the patient and remove device if patient complains about toes
falling asleep or technician observes color change in the foot.

NOTE: All short leg splints(SLS) are applied in neutral position (90 degrees dorsiflexion) absent of
inversion and eversion, unless otherwise indicated by physician.
b. Maintain ankle at a 90 degree angle to the tibia.
c. Hold each end of the plaster sheets, place in bucket of tepid water and remove when bubbles
cease to rise.
d. Squeeze the splint together.
NOTE: Squeezing the roll together equally distributes the water. Wringing the roll quickens the drying
time of the splint and may cause the plaster not to cure.
e. Place the plaster sheets centered and 1/2 inch from the edge of the padding and laminate
plaster.
f. Laminate plaster splint.
g. Fold over the edges of the padding.
h. Place additional layer of webril padding over folded edges.
i. Place the padded splint on posterior side of the leg from the tips of the toes to 3 inches distal
to the popliteal space.

12. Secure the splint to injured leg.
a. Place the edge of the elastic bandage at the base of the phalanges and begin wrapping
around the foot two rotations to secure the edge .
b. Continue down the foot and leg until the padding is completely covered.
c. Fold down and hold excess ends of the padding while continuing to wrap the bandage until
the padding is completely covered.
d. Secure elastic bandage with clips temporary.
e. Tape down the elastic bandage between the clips.
f. Remove the clips and dispose in trash receptacle.
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