Page 280 - Orthopedic Casts and Splints2

Performance Steps
NOTE: The plaster reinforcement splints are designed to assist in reinforcing the cast at the knee
region..
a. Locate edge of two stacks .
b. Measure on the medial and lateral sides of the leg 4inches distal to the groin crossing the
knee and ending at the calf muscle.
NOTE: The splints could also be applied on the medical/lateral side of the cast. The application of the
splint is technician preference.
c. Place (2)stacks of ( 5) plaster sheets next to the measured length , cut off excess amount
and place on work cart/station.
NOTE: All excess materials will be discarded in trash receptacle.
11. Prepare plaster reinforcement splint for use at the greater trochanter.
NOTE: The plaster reinforcement splints are designed to assist in reinforcing the cast at the greater
trochanter .
a. Locate edge of one stack .
b. Measure the length of the greater trochanter.
c. Place stack of ( 5) plaster sheets next to the measured length , cut off excess amount and
place plaster sheets on work cart/station.
NOTE: Disregard excess materials in trash receptacle.
12. Apply stockinette to patient's injured leg.
a. Apply elastic knee cage to leg.
b. Apply quadrilateral socket to thigh.
NOTE: Physician's order will indicate use of quadrilateral socket. When using the quadrilateral socket
having the patient stand will provide a better fit at the base of the thigh.
c. Hold open sides of the stockinette.
d. Instruct patient to place injured foot in the opening of the stockinette.
e. Roll stockinette on injured ankle/leg resting 1 inch distal to the toes to 3 inches proximal to
the greater trochanter.
NOTE: The patient may assist in rolling the stockinette past the greater trochanter
f. Pinch the stockinette at the base of the tibia/fibula and make a cut at a 45 degree angle.
g. Pinch the stockinette at the back of knee and make a cut at a 45 degree angle.
NOTE: Cutting the stockinette reduces the chance of pressure sores developing from the stockinette
rubbing or bunching up under the cast.

13. Position the patient's injured ankle at a 90 degree angle to the tibia.
NOTE: There are several ways to obtain a 90 degree angle. The patient could maintain the position,
nursing personnel or family member can assist. A thigh holder, or thigh stand could be used. It is the
technician preference.
a. Instruct patient to dorsiflex foot.
NOTE: Many patient's will not know the meaning of dorsiflex. Instruct the patient to pull their toes
towards their head or have the patient simulate squishing a bug with their heel. Either technique will
assist the patient in maintaining the ankle at 90 degrees. Each technician may use their own
techniques.
b. Align the 2nd and 3rd phalanges with the knee.
NOTE: Aligning the phalanges with the knee reduces eversion or inversion of the foot.
c. Have assistant grasp the metatarsals of the injured foot under the stockinette.
NOTE: Grasping the metatarsals under the stockinette, reduces the chance the foot will be inverted or
everted.
d. Have assistant place opposite forearm under the patient's injured knee.
NOTE: Bracing the forearm under the knee reduces muscle strain for the patient, assists with ankle
angle and knee flexion.

14. Measure patient's injured ankle w/ goniometer.

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