Page 342 - Orthopedic Casts and Splints2

Performance Steps
NOTE: Do not wring the sheet, this will cause the roll to dry more quickly
d. Place the plaster sheets centered and 1/2 inch from the edge of the padding .
e. Laminate plaster splint.
f. Fold over the edges of the padding.
g. Place additional layer of padding over folded edges.
h. Place the padded splint from the tips of the injured phalanges to 1 inch distal to the cubitum
space.

13. Secure radial gutter splint to injured phalanges and arm.
a. Hold elastic roll with one hand.
b. Place the edge of the elastic bandage on the radial styloid and begin wrapping around the
wrist two rotations to secure the edge .
c. Continue through the palm, around the index and middle phalanges to 1 inch distal to the
cubitum space.
d. Secure elastic bandage with clips at back of wrist.
e. Tape down the elastic bandage between the clips.
f. Remove the clips and dispose in trash receptacle.

14. Mold casting material to forearm/wrist.
NOTE. The interosseous mold is used to prevent movement of the wrist in the cast and promote fracture
healing .
a. Place the heel of one hand on the volar aspect of the distal wrist.
b. Place the heel of the second hand on the dorsal aspect of the distal wrist.
c. Squeeze the heels of each hand together.
d. Apply firm and gradual pressure beginning at the wrist and progress up the forearm.
CAUTION: Excessive pressure may result in further patient injury. Talk to the patient while performing
this procedure ( e. g. How do you feel?, Is the pressure too much ? )
e. Maintain patient's wrist in correct position.
f. Remove heels of each hand from splint when contours of the wrist and forearm have been
shaped and splint is cured.

15. Mold casting material to 2nd and 3rd metacarpals.
NOTE. This mold is used to prevent movement of the metacarpals in the splint and promote fracture
healing .
a. Place heel of hand on the dorsal aspect of the injured phalanges and apply gradual pressure.
NOTE: The physician may apply an additional mold.
b. Maintain patient's injured phalanges in correct position.
c. Remove palm of hand from splint when contours of the phalanges and wrist have been
shaped, the phalanges are between 70- 90 degrees of flexion and the splint is cured.
16. Check range of motion ( ROM ) of phalanges.
a. Have patient extend and flex uninjured fingers.
b. Have patient rotate thumb.

17. Check alignment of injured wrist and injured fingers with goniometer (go to steps 10-11).
NOTE: If wrist is not within 0-15 degrees of dorsal extension, the 1st and 2nd phalanges are not within
70-90 degrees of flexion, ulnar or radial deviation are present, remove splint and return to step 11.

18. Check splint dimensions.
a. The splint edge is 1 inch distal to the cubitum space.
b. The splint is covering both the 1st and 2nd metacarpals and is 1/2 inch distal to the injured
phalanges.
NOTE: If splint is not covering the 1st and 2nd metacarpals and not distal to the injured phalanges
remove splint and go to step 10.
c. The edge of the splint is 1/2 inch distal to the injured phalanges tips.
19. Check patient's capillary refill.

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