Page 229 - Orthopedic Casts and Splints2

Performance Steps
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. Measure patient's injured knee w/ goniometer.
a. Place the stationary arm of the goniometer bisecting the fibula.
b. Place the moving arm of the goniometer bisecting the femur.
c. Place the protractor of the goniometer on the lateral aspect of the knee.
d. Set the knee until the goniometer measures between 0-15 degrees of flexion.
NOTE: Nursing personnel or orthopaedic props ( e.g. orthopaedic bump, pillow)) may assist the patient in
maintaining the correct knee angle.

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 toes are falling
asleep or technician observes color changes in the foot.

12. Apply posterior splint to injured leg.
NOTE: All Long leg splint (LLS) are applied in neutral position (90 degrees dorsiflexion) absent of
inversion and eversion with knee flexed between 0-15 degrees, unless otherwise indicated by physician.
a. Hold the ends of the plaster sheets, place in bucket of tepid water and remove when bubbles
cease to rise.
b. Squeeze the splint together.
NOTE: Squeezing the plaster sheets together equally distributes the water. Wringing the sheets quickens
the drying time of the splint and may cause the plaster not to cure.
c. Place the plaster sheets centered and 1/2 inch from the edge of the padding and laminate
plaster.
d. Fold over the edges of the padding.
e. Place additional layer of webril padding over folded edges.
f. Place the padded splint on posterior side of the leg from 4 inches distal to the groin or the
gluteal crease to the tips of the toes
13. Secure long leg splint to injured leg.
a. Hold elastic roll with one hand.
b. Place the edge of the elastic bandage at the tips of the toes and begin wrapping around the
fore foot.
c. Continue around the malleolus up the leg.
d. Wrap a figure of eight around the knee.
e. Fold down and hold excess ends of the padding while continuing to wrap the bandage until the
padding is completely covered.
f. Secure elastic bandage with clips.
g. Tape down the elastic bandage between the clips.
h. Remove the clips and dispose in trash receptacle.
i. Place pillow under injured leg.
14. Mold the splint to the ankle/knee/leg
a. Place palm of hand on the gastrocnemius and apply pressure. Hold until contours takes shape.
b. Place lateral aspect of both thumbs on the malleolus and apply even pressure. Hold until
contours take shape.
c. Place palm of hand on the calcaneus and apply pressure. Hold until contour takes shape.
d. Place palm of hand on the plantar arch and apply pressure. Hold until contour takes shape.
e. Place palm of hand on the hamstring region and apply pressure. Hold until contour takes
shape.

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