Page 25 - Orthopedic Casts and Splints2

Performance Steps
NOTE: Inform nurse if skin conditions are present before continuing.
d. Pad medial/lateral malleolus(ankle) of the injured leg.
NOTE. Webril or orthopaedic felt may be used. Padding is used to reduce any chafing of the skin that
may occur while injured leg is in Buck's traction .
9. Check patient's capillary refill of both feet.
CAUTION: Prior to starting any procedure on a patient, circulation is always checked.
a. Squeeze patient's toes and nail beds will turn white .
b. Release patient's toes and nail bed will return pink .
CAUTION: If capillary refill is delayed for more than 2 seconds inform physician and follow physician's
order.

10. Apply skin adherent to patient's injured leg.
Note: The technician should use tincture of benzoin/mastisol adhesive in conjunction with
adhesive/non adhesive vent foam straps.
a. Pad the malleolus with webril.
b. Ask patient if they have ever had a skin rash after the use of benzoin or after eating shell
fish.
NOTE: If patient is unable to answer, ask family member . If family member is not present use a
substitute application(e.g. mastisol).
c. If no known allergies apply tincture of benzoin to the medial/lateral aspect of the injured leg
beginning one inch distal to the fibula notch/head and ending one inch proximal to the
malleolus(ankle)
d. If known allergies apply mastisol as in step 10c.
11. If using vent foam strap go to step 13

12. If using Buck's traction boot go to step 14.
13. Secure the vent foam strap with spreader block to injured leg.
NOTE: The vent foam strap upon being secured should rest 1 inch distal to the fibular notch.
a. Place vent foam strap beginning 1 inch proximal to the fibular notch/head, down the medial
side of the leg, continuing around the heel and ending on the lateral side opposite the start.
b. Place the edge of the elastic bandage on the malleolus and begin wrapping around the
malleolus two rotations to secure the edge
c. Fold down and hold excess ends of the vent foam strap.
d. Continue up the leg until the vent foam strap is completely covered and secure with clips.
NOTE: Depending on the size of the patient's leg a second elastic bandage may be necessary to
completely cover the vent foam strap.
e. Tape down the elastic bandage between the clips.
f. Remove the clips and dispose in trash receptacle.
g. Slide the spreader block between the vent foam strap.

14. Open and slide Buck's traction boot under injured leg to 1 inch distal to the fibular notch and
secure with straps.
CAUTION: When applying Buck's traction boot, assistance must be used to prevent further injury to the
patient. The Buck' s boot is available in small, medium and large.
15. Secure the 5 or 9 inch single clamp bar ( horizontally) to crossbar at foot of bed in alignment with
the 2nd and 3rd phalanges (toes) of the injured leg/foot.
16. Secure the pulley attachment to the middle of the single clamp bar.

17. Tie traction cord to spreader block and weight carrier.
a. Remove 4-6 feet of traction cord from the spool.
b. Cut traction cord.
c. Tie a non slip knot to the end of spreader block.

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