Page 282 - Orthopedic Casts and Splints2

Performance Steps
NOTE: Open one fiberglass package at a time. As fiberglass comes in contact with the air, the roll will
start to cure (set up ).
20. Apply 2 plaster/fiberglass rolls.
NOTE: If using plaster, 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 vertically with one hand.
b. With opposite hand unroll the plaster/fiberglass 1/2 -1 inch and grasp the edge with thumb,
index and middle fingers.
NOTE: Alternate method of placing the thumb under the forward edge of the roll can also be used.
c. Place plaster/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 at the distal aspect of the tibia/fibula and begin
wrapping around the malleolus two rotations.
NOTE: The technician may also start 1 inch distal to the edge of the webril.
f. Continue up the foot and leg, figure eight around the knee ending 1 inch distal to the 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.
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.
21. Laminate the casting materials.
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 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 begins to cure.
22. Apply plaster splint to posterior aspect of cast.
NOTE: Plaster reinforcement splint is used to strength 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 on the posterior side of the cast in line with the web spacing of
the foot and gluteal crease.
d. Laminate the splint to the cast.
e. Maintain patient's ankle at 90 degree dorsiflexion.
NOTE: Instruct the patient to squish a bug with their heal 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.
23. Apply plaster splint to quadriceps muscle/greater trochanter region.
a. repeat steps 22 a and b.
b. Place reinforcement splint on the lateral side of the cast in line with the superior aspect of
the greater trochanter and the medial aspect of the quadriceps muscle.
c. Laminate the splint to the cast.
24. Apply 2 plaster/fiberglass rolls ( repeat steps 20-21 )

279