Page 290 - Orthopedic Casts and Splints2

Performance Steps
b. With 2nd hand unroll the webril 1/2 - 1inch and grasp edge with index and middle finger .
c. Place the edge of the webril on the ulnar styloid and begin wrapping around the wrist two
rotations.
NOTE: The webril application is started at the wrist to provide an anchor and extra padding to the ulnar
styloid.

CAUTION: Keep the cast padding on the extremity throughout the application to avoid circulation
compromise of the patient's hand/fingers.
d. Continue through the palm ending 1/2 inch from the distal edge of the stockinette, back up the
forearm 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.
NOTE: The cast padding can be cut or torn (horizontally ) when wrapping through the palm to provide a
better fit. The technician preference will determine which technique to use.
15. Prepare casting materials.
a. If using fiberglass casting materials go to step 15.
b. If using plaster casting materials go to step 17.
16. Place fiberglass casting gloves on hands.
Caution: The use of fiberglass casting gloves are mandatory to prevent the technician from receiving
chemical burns while applying a fiberglass cast.

17. Open fiberglass casting package and go to step 18.
NOTE: Open one fiberglass package at a time. As fiberglass roll comes in contact with the air, the roll will
start to cure and harden.
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 with one hand.
NOTE: Alternate method may 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 vertical into 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 on the ulnar styloid and begin wrapping around the wrist
two rotations to secure the edge .
NOTE: The cast is most susceptible to losing strength in the palm region. Therefore, a twitching or cut
method is authorized.

The Twisting method: As the roll is pushed through the palm pinch the sides of the plaster roll together
(not recommended for fiberglass) and twist . Evenly space the casting material on the webril and
smooth out with volar side of fingers. The twisting method provides strength to the cast .

The CUT method: As the roll is pushed through the palm make a horizontal cut to the proximal edge of
the plaster/fiberglass roll and smooth out with volar aspect of fingers or palm.The cutting method
provides cast cosmetics. Each technician may have their own preference to these methods.

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