Page 234 - Orthopedic Casts and Splints2

Performance Steps

11. Measure patient's injured ankle with goniometer.
a. Position the patient's injured ankle at a 90 degree angle to the tibia.
NOTE: There are several methods to maintain the patient's ankle at a 90 degree angle. The patient could
flex their foot with toes pointing towards their head, nursing personnel or family member may assist, or
place the patient in the prone position with toes pointing down. It is the technician preference.
b. Place the stationary arm of the goniometer parallel to the fibula.
c. Place the moving arm of the goniometer in line with the lateral edge of the heel and the head of
the fifth metatarsal ( little toe ).
d. Place the protractor of the goniometer on the lateral malleolus.
e. Set the ankle until the goniometer measures 90 degree of dorsiflexion.
NOTE: To assist the patient in maintaining the ankle at a 90 degree angle, have the patient bend the
knee, point toes toward their head or simulate squashing a bug with the heel of the foot. This will assist in
maintaining the ankle at the correct angle.

NOTE: The technician may use their own style to assist the patient.
12. Apply purified cotton roll to the injured ankle foot and leg.
a. Place thigh holder under patient's injured leg ( hamstring region)
CAUTION: Depending on the orthopaedic device used, circulation is a major concern. Always
communicate with the patient and remove device if patient complains about toes falling asleep or
technician observes color change in the toes/foot.
b. Place the edge of the cotton roll at the tips of the phalanges and begin wrapping around the
foot two rotation to secure the edge.
c. Continue down the foot and leg to 3 inches distal to the popliteal region.
d. Secure the cotton with kerlix roll.
NOTE: The second cotton roll may be used if necessary.

13. Apply posterior splint to injured leg.
NOTE: All short leg splints are applied with ankle in neutral position ( 90 degrees of dorsiflexion ), absent
of inversion and eversion, unless otherwise indicated by physician's order.
a. Grasp each end of the stack of plaster sheets, place in bucket of tepid water and remove when
bubbles cease to rise.
NOTE: The absent of bubbles indicates the plaster sheets are equally saturated with water.
b. Squeeze the sheets together.
NOTE: Squeezing the 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 plaster sheets on work cart/station and laminate .
d. Place the splint on the posterior side of the leg from the tips of the phalanges to 3 inches distal
to the popliteal region.

14. Secure the splint to the injured leg.
a. Place edge of the elastic bandage at the base of the phalanges and begin wrapping around the
foot two rotations to secure the edge.
b. Continue down the foot and leg.
c. Fold down and hold excess ends of the splint while continuing to wrap the bandage until the
splint and cotton are completely covered.
d. Secure elastic bandage with clips temporarily
e. Tape down the elastic bandage between the clips.
f. Remove the clips and dispose in trash receptacle.

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

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