Page 236 - Orthopedic Casts and Splints2

Performance Steps
a. Open kerlix fluff package.
b. Remove and unfold kerlix fluffs
c. Place kerlix fluffs between each phalange.
NOTE: Kerlix fluffs are placed between each phalange to the middle knuckle(PIP) of each phalange.
More than one kerlix fluff may be needed.

23. Secure fluffs with kerlix roll.
a. Hold kerlix roll with one hand.
b. Place the edge of the kerlix roll on the ulnar styloid and begin wrapping around the wrist two
rotations to secure the edge .
c. Continue through the palm, fan folding between the phalanges back up the forearm ending 1
inch distal to the cubitum space.
NOTE: The kerlix roll should be applied snugly to provide compression to the injured hand.

24. Apply volar 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 on work cart/station.
d. Laminate plaster splint.
e. Place the splint on the volar aspect of the hand aligned with the DPC and the thenar muscle.
f. Secure kerlix fluffs with kerlix roll.

25. Secure volar splint to injured arm.
a. Hold elastic roll with one hand.
b. Secure the elastic bandage on the ulnar styloid by wrapping 2 rotations around the wrist.
NOTE: Pull the elastic bandage snugly to compress the swelling.
c. Continue through the palm, phalanges and back up the forearm ending 1 inch distal to the
cubitum space.
d. Secure elastic bandage with clips.
e. Tape down the elastic bandage between the clips.
f. Remove the clips and dispose in trash receptacle.

26. 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. Remove heels of each hand from splint when contours of the wrist and forearm have been
shaped and the splint is cured.
27. 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.

28. Check alignment of injured wrist with goniometer.
a. Place the stationary arm of the goniometer vertically , bisecting the forearm.
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.

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