Page 202 - Orthopedic Casts and Splints2

Performance Steps

13. Apply medial/lateral(U) splint to injured leg.
a. Follow steps 11c- h.
b. Place the padded splint on medial side of the leg around the heel and up the lateral aspect
of the leg 3 inches distal to the popliteal space.
c. Follow step 12.

14. Mold the splint to the ankle/leg
a. Place palm of hand on the gastrocnemius muscle and apply pressure. Hold until the contour
takes shape.
b. Place lateral aspect of both thumbs on the malleolus and apply even pressure. Hold until
the contour takes shape.
c. Place palm of hand on the calcaneus and apply pressure. Hold until the contour takes
shape.
d. Place palm of hand on the planter arch and apply pressure. Hold until the contour takes
shape.

15. Check range of motion ( ROM ) of phalanges and knee.
a. Have patient extend, flex toes.
b. Have patient extend and flex knee.

16. Check alignment of injured ankle with goniometer.
a. Place the stationary arm of the goniometer parallel to the fibula.
b. Place the moving arm of the goniometer vertically, bisecting the 5th MTPJ.
c. Place the protractor of the goniometer on the lateral malleolus.
d. The goniometer should measure 90 degrees of dorsiflexion.
NOTE: If the malleolus is not at 90 degrees of dorsal flexion, everted or inverted remove splint and go
to step 8 to repeat process.
17. Check splint dimensions.
a. The tips of the toes are visible.
b. The splint edges rest one inch below the fibula head/notch( or 3 inches distal to the popliteal
space) to the tips of the toes.

18. 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.

19. Clean plaster 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 .

20. Administer a crutch ambulation treatment ( Task 081-836-0041).
21. Give patient verbal and written instructions on cast care.
a. Instruct patient to call the cast clinic should they have any concerns or questions regarding
their cast. Provide patient with a copy of the clinic hours and telephone number. After duty
hours instruct patient to report to the Emergency Room.
b. Present patient with cast care booklet or some form of written instruction .
c. Instruct patient to keep leg elevated and flex and extend toes to increase circulation in the
foot.
d. Instruct patient not to stick any objects down the splint , do not remove the splint, and do not
alter the splint ( e. g. writing or coloring the cast).
e. Instruct patient to use crutches when walking.

22. Annotate the procedure applied to patient in medical record or SF 513.

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