Page 217 - Orthopedic Casts and Splints2

Performance Steps
CAUTION: The temperature of the water must be tepid ( 70-80 degrees) to reduce further injury
(possible burns) to the patient. The technician should draw room temperature water and initially use a
thermometer to gauge water temperature.

CAUTION: The technician must change the water after each application as the residue in the cast
bucket will act as an accelerator causing the casting material to increase in heat emission.
7. Assemble materials to include webril, plaster rolls, examination gloves, hospital pad (chux), bed
sheet, sling, plaster reinforcement sheet, alcohol pads/damp towel. Open and remove (2) plaster
rolls from packages and place on work cart/station.
NOTE: Physician's order, technician's preference, availability of supplies, and/or patient's extremity size
will determine which casting material (fiberglass/plaster) will be used.
8. Prepare cast padding ( webril) for volar splint.
a. Place work cart with orthopaedic bump at the edge of the bed.
b. Place hospital pad or bed sheet on patient's lap.
NOTE: All patient's should be given a covering( e.g. chux, bed sheet) to reduce damaging their clothing
during the casting process.
c. Position the patient's uninjured elbow on the bump at a 45 degree angle to the upper torso.
Locate the DPC and base of the thenar muscle.
NOTE: The DPC is the distal diagonal line on the volar aspect of the hand. The thenar muscle is at the
base of the thumb on the medial side.
d. Measure from 1 inch distal to the DPC to 1 inch distal to the cubitum space.
e. Place webril on work cart/station.
f. Roll out second layer and place lengthwise on the middle of the previous padding.
g. Layer the padding 2-4 thickness.
9. Prepare plaster splint for the volar aspect of the hand.
a. Open box of 4 x 15 plaster reinforcement sheets. Remove sheets from box and unwrap
package . Peel back the edges of (10-15) sheets, remove from the stack. Place on work
cart/station.
NOTE: The technician may choose to use 4 inch plaster rolls.
b. Locate DPC, thenar muscle and the cubitum space.
c. Remove (1) plaster sheet from the stack of (10-15).
d. Place sheet next to uninjured arm to obtain sheet length, the DPC and thenar muscle contours
.
NOTE: To increase patient cleanliness the sheet does not have to rest on the patient skin.
e. Draw a diagonal line on the plaster sheet that matches with the DPC of patient's hand.
NOTE: The diagonal line which will be cut will facilitate free ROM of the fingers (extension and flexion).
f. Draw a curved line(half moon shape) on the plaster sheet that matches with the outer
border of the thenar muscle on the patient's hand
NOTE: The half moon pattern enables the thenar muscle to be observable and the thumb to adduct to all
fingers promoting free range of motion (ROM).
g. Place sheet on stack, cut the outlined patterns and excess length for all sheets, and place on
work cart/station for later use.
NOTE: Discard excess material in the trash receptacle.
10. Measure patient's injured wrist w/ goniometer.
a. Position the patient's injured elbow on the bump at a 45 degree angle to the upper torso
b. Place the stationary arm of the goniometer bisecting the lateral aspect of the ulnar.
c. Place the moving arm of the goniometer bisecting the 5th phalange.
d. Place the protractor of the goniometer on the ulnar styloid.
e. Set the wrist until the goniometer measures between 0-15 degrees of dorsal extension.
11. Apply volar splint to injured arm.
NOTE: Assistance may be used prior to securing splint.

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