Page 218 - Orthopedic Casts and Splints2

Performance Steps
a. Place the plaster sheets in bucket of tepid water and remove when bubbles cease to rise.
b. Squeeze the sheets together to eliminate excess water.
NOTE: Do not wring the sheet, this will cause the roll to dry up quickly
c. Place the plaster sheets centered and 1/2 inch from the edge of the padding .
d. Laminate plaster splint.
e. Fold over the edges of the padding.
f. Place additional layer of padding over folded edges.
g. Place the padded splint on the volar aspect of the hand aligned with the DPC and the thenar
muscle.
12. Secure volar splint to injured arm.
a. Hold elastic roll with one hand.
b. Place the edge of the elastic bandage on the ulnar styloid and begin wrapping around the wrist
two rotations to secure the edge .
c. Continue through the palm and back up the forearm covering all the padding.
d. Secure elastic bandage with clips.
e. Tape down the elastic bandage between the clips.
f. Remove the clips and dispose in trash receptacle.

13. Mold the splint to forearm/wrist.
NOTE. The interosseous mold is used to prevent movement of the wrist in the cast and promote fracture
healing .
a. Place the heel of one hand on the volar aspect of the distal wrist.
b. Place the heel of the second hand on the dorsal aspect of the distal wrist.
c. Squeeze the heels of each hand together.
d. Apply firm and gradual pressure beginning at the wrist and progress up the forearm.
CAUTION: Excessive pressure may result in further patient injury. Talk to the patient while performing
this procedure ( e. g. How do you feel?, Is the pressure too much ? )
e. Maintain patient's wrist in correct position.
NOTE: The patient's wrist should be in the cock up position( thumb and index finger in opposition to each
other)
f. Remove heels of each hand from splint when contours of the wrist and forearm have been
shaped and splint is cured.
14. Check range of motion ( ROM ) of phalanges and elbow.
a. Have patient extend, flex fingers and touch thumb to all fingers.
b. Have patient extend and flex elbow.
15. Check alignment of injured wrist with goniometer.
a. Place the stationary arm of the goniometer vertically , bisecting the ulnar.
b. Place the moving arm of the goniometer vertically, bisecting the lateral side of the 5th
phalange (little finger)
c. Place the protractor of the goniometer on the ulnar styloid.
d. The wrist is measured between 0-15 degrees of dorsal extension.
NOTE: If wrist is not within 0-15 degrees of dorsal extension, ulnar or radial deviation are present,
remove splint and go to step 9.
16. Check splint dimensions.
a. The splint edge is resting on the DPC .
b. The edge of the splint is resting on thenar muscle border .
17. Check patient's capillary refill.
a. Squeeze patient's fingers and nail beds will turn white .
b. Release patient's fingers and nail beds will return pink.
CAUTION: If capillary refill is delayed for more than 2 seconds inform physician and follow physician's
instruction.

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