Page 258 - Orthopedic Casts and Splints2

Performance Steps

18. Apply 1st plaster/fiberglass roll.
NOTE: Examination gloves are recommended to protect the technician's hands as the resin in the
plaster rolls may cause the skin on the hands to dry up.
a. Hold plaster or fiberglass roll vertical with one hand.
NOTE: Two hands may also be used.
b. With opposite hand unroll the plaster or fiberglass 1/2-1 inch and grasp edge with thumb,
index and middle fingers.
NOTE: Placing the thumb under the forward edge of the roll can also be used.
c. Place the plaster or fiberglass roll in bucket of tepid water and remove when bubbles
cease to rise.
CAUTION: Removing the casting material when bubbles are present ensures dry spots will be visible
during application. Dry spots cause integrity break down of the cast.
d. Squeeze the roll together(do not wring the roll).
NOTE: To evenly distribute the water and prevent telescoping of the roll during application gently
squeeze the roll inward.
e. Place the edge of the casting material distal to the edge of the felt padding and begin
wrapping around the foot two rotations to secure the edge .
f. Continue up the leg ending 1/2 inch distal to the edge of the stockinette.
g. With each turn overlap the plaster/fiberglass by 1/2 or 1/4 the previous wrap. The top of the
plaster/fiberglass should bisect the middle of the previous layer and present an evenly
applied cast.
CAUTION: All bulges or wrinkles must be eliminated. If wrinkles develop, remove casting material and
go to step 10 .

NOTE: To reduce possible constrictive edema caused by applying the plaster/fiberglass too tight, keep
the plaster/fiberglass roll on the extremity as it is applied.
19. Laminate the casting material.
a. Place palm of each hand on the cast.
CAUTION: To reduce cast indentations, which can cause pressure sore to the patient's skin under the
cast, keep finger tips off the cast during application and molding process. If the patient feels pressure
sore or hot spots developing under the cast, the cast must be removed immediately.
b. Rub the cast material in the direction it was applied.
NOTE: Laminating the cast material fills in the pores which assist it providing strength to the cast.
c. Continue rubbing the cast until the tone/texture changes from a glossy/creamy color to a dull
white color.

20. Apply reinforcement splint to posterior aspect of cast.
NOTE: The reinforcement splint is used to strengthen and support the cast.
a. Place the splint in tepid water, wait for bubbles to subside and remove splint from water.
b. Squeeze the splint together to eliminate excess water.
c. Place reinforcement splint to the posterior aspect of the cast from 3 inches distal to the
popliteal space to tip of toes and laminate the splint.
d. Maintain patient's ankle at 90 degrees of dorsal flexion until splint adheres to cast material.
NOTE: Instruct the patient to squash a bug with their heal of their foot or bring their toes to their nose.
Either technique will assist the patient in bringing their ankle to a 90 degree angle. The technician may
have their own preference to the above techniques.
21. Apply 2nd plaster/fiberglass roll( repeat steps 18 -19)

22. Mold the cast material to the lower leg.
a. Place palm of hand on the gastrocnemius muscle and apply pressure. Hold until contours
takes shape.
NOTE: A flat board can also be used to mold to the gastrocnemius muscle.

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