Page 269 - Orthopedic Casts and Splints2

Performance Steps

3
Medial view of PTB

NOTE: The PTB cast eliminates rotation of the tibia( bone on the medial side of the leg) and fibula (
bone on the lateral side of leg). The knee has full extension and the ankle is immobilized at a 90
degree angle. (Refer to Figure 3-x)

NOTE: Instruct the patient that during the cast application a chemical response(exothermic reaction)
will occur between the water (H2O) and the plaster ( gypsum). This is a safe and common occurrence.
The cast will initially become warm and cool down within 2-5 minutes. However, if the cast doesn't
cool down or there is an increase of heat intensity during the application process, inform the technician
and the cast may need to be removed.

4. Inspect injured leg/ankle with patient supine on the examination bed.
a. Place examination gloves on hands.
CAUTION: Always practice Body Substance Isolation (BSI) prior to applying traction, splints or casts
to patients.
b. Remove shoes and socks from both feet. Roll pant leg above the knee.
NOTE: If patient is unable to get pant leg above knee, provide patient with paper shorts or hospital
gown. If unavailable, cut the pants at the seam.
c. Examine both legs for jewelry and remove if found.
NOTE: All jewelry must be removed. Give jewelry and clothing items to family member or secure with
patient's belongings in NCOIC office.

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