Page 316 - Orthopedic Casts and Splints2

Performance Steps

16. Apply 1st plaster/fiberglass roll.
NOTE: Examination gloves are recommended when using plaster 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 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 on the ulnar styloid and begin wrapping around the
wrist two rotations to secure the edge (Refer to Figure 3-x).
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) twist and evenly space the casting material on the webril.
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.
f. Continue through the palm, around the thumb, back up the forearm, ending 1/2 inch
proximal to the edge of the webril (Refer to Figure 3-x).
g. Overlap the plaster/fiberglass by 1/2 or 1/4 the previous wrap. The top of the
plaster/fiberglass should bisect the middle of the previous layer and present an evenly
applied cast.
17. Laminate the casting material.
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( Refer to figure 3-x).
NOTE: Laminating the cast material fills in the pores which assist it providing strength to the cast.
c. Continue rubbing the cast until the tone/texture changes from a glossy/creamy color to a dull
white color
18. Apply reinforcement splint to radial 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 subside and remove splint from water.
b. Squeeze the splint together to eliminate excess water.
c. Place reinforcement splint on the radial side of the cast around the thumb.
d. Laminate splint on cast.
e. Maintain patient's wrist between 0-15 degrees of dorsal extension and thumb in opposition to
the index finger.
NOTE: Maintain patient's thumb and index finger in opposition to one another.
19. Apply 2nd plaster/fiberglass roll( repeat steps 16-17 ).

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