Page 224 - Orthopedic Casts and Splints2

Performance Steps

11. Measure patient's injured elbow w/ goniometer.
a. Place the stationary arm of the goniometer bisecting the lateral aspect of the humerus.
b. Place the moving arm of the goniometer bisecting the forearm.
c. Place the protractor of the goniometer on the olecranon process ( elbow ).
d. Set the elbow until the goniometer measures 90 degrees of flexion.

12. Apply single tong splint to injured arm.
NOTE: Assistance may be used prior to securing splint.
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 from the base of the MCPJ's posteriorly around the elbow to the
DPC.
NOTE: The elbow should be flexed at 90 degrees.
13. Secure sugar tong 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, back up the forearm and figure of eight around the elbow.
d. Secure elastic bandage with clips.
e. Tape down the elastic bandage between the clips.
f. Remove the clips and dispose in trash receptacle.
14. 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 while
maintaining the wrist in correct position.
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.
f. Remove heels of each hand from splint when contours of the wrist and forearm have been
shaped and splint is cured.
15. Mold splint to elbow.
a. Place the heel of one hand on the anterior aspect of the elbow.
b. Place the heel of one hand on the posterior aspect of the elbow.
c. Apply firm and gradual pressure at the elbow and maintain the elbow in correct position.
d. Remove heels of each hand from splint when contours of the elbow have been shaped and
splint is cured.

16. Check range of motion ( ROM ) of phalanges/shoulder.
a. Have patient extend and flex fingers.
b. Have patient abduct and adduct shoulder.
17. Check alignment of injured wrist/elbow with goniometer.
a. Place the stationary arm of the goniometer vertically, bisecting the ulnar.

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