Page 272 - Orthopedic Casts and Splints2

Performance Steps
d. Continue down the foot ending 1/2 inch from the distal stockinette, back up the leg ending
1/2 inch from the proximal edge of the stockinette.
e. With each turn overlap the webril by 1/2 -1/4 the previous wrap. The top of the webril should
bisect the middle of the previous layer covering up the shallow line and present evenly
applied padding. To reduce possible constrictive edema caused by applying webril too tight,
keep the webril on the extremity as it is applied.
14. Prepare casting materials.
a. If using plaster rolls, go to step 17 .
b. If using fiberglass rolls, go to steps 15 and 16.

15. Place fiberglass casting gloves on hands.
CAUTION: To prevent chemical burns to the hands it is mandatory for the technician to use fiberglass
casting gloves .

16. Open fiberglass casting package and go to step 17 .
NOTE: Open one fiberglass package at a time. As fiberglass comes in contact with the air, the roll will
start to cure (set up ).
17. Apply 1st plaster/fiberglass roll.
NOTE: Examination gloves are recommended to protect the technician's hands as the resin in the
plaster may cause the skin on the hands to dry up.
a. Hold plaster/fiberglass roll vertical with one hand.
NOTE: Orthoflex should be used first to obtain a effective mold around the condyles.
b. With opposite hand unroll the plaster/fiberglass 1/2 -1 inch and grasp the edge with thumb,
index and middle fingers.
NOTE: Placing the thumb under the forward edge of the roll can also be used.
c. Place plaster/fiberglass roll vertical in bucket of water and remove when bubbles cease to
rise.
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 at the distal aspect of the tibia/fibula and begin
wrapping around the malleolus two rotations.
NOTE: The technician may also start 1 inch to the distal edge of the webril.
f. Continue down the foot ending 1/2 inch from the distal edge of the webril , back up the leg
ending 1/2 inch from the proximal edge of the webril.
g. With each turn overlap the plaster/fiberglass by 1/4 -1/2 the previous wrap. The top of the
plaster/fiberglass should bisect the middle of the previous layer and present evenly applied
casting material. 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.

18. Laminate the cast.
a. Place palm of each hand on anterior and posterior aspect of 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 excessive
pressure 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 plaster cast until the tone/texture changes from a glossy/creamy color
to a dull white color. If using fiberglass continue to laminate until the cast is cured.

19. 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 cease to rise and remove splint from
water.
b. Squeeze the splint together to eliminate excess water.

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