Page 37 - Orthopedic Casts and Splints2

Performance Steps
d. Pad medial/lateral malleolus ( ankle) of injured leg.
NOTE: Webril, felt or surgipads may be used. Padding is used to reduce any chaffing that may occur
while the patient's injured leg is in Russell's traction.

9. Check patient's capillary refill of both feet.
CAUTION: Prior to starting and finishing any procedure on a patient, circulation is always checked.
a. Squeeze the patient's toes and nail beds will turn white.
b. Release patient's toes and nail beds will return pink .
CAUTION: If capillary refill is delayed for more than 2 seconds inform physician and follow physician's
order.

10. Apply skin adherent to injured leg.
Note: The technician should use tincture of benzoin/mastisol adhesive in conjunction with
adhesive/non adhesive vent foam straps.
a. Ask patient if they have ever had a skin rash after use of benzoin or after eating shell fish.
NOTE: If patient is unable to answer, ask family member. If family member is not present use a
substitute application ( mastisol )
b. If no known allergies exists apply tincture of benzoin to the medical/ lateral aspect of the
injured leg beginning one inch distal of fibula notch/head and ending at the malleolus ( ankle
).
c. If known allergies exists apply mastisol in the same manner as 10b.

11. Secure vent foam strap or Buck's boot with spreader block to injured leg.
NOTE: Product availability and patient's leg size will determine whether the adhesive vent foam strap
or the Buck's boot is used.
a. If using vent foam strap go to step 12.
b. If using Buck's traction boot go to step 13.
12. Secure the vent foam strap with spreader block to injured leg.
NOTE: The vent foam strap upon being secured should rest 1 inch distal to the fibular notch.
a. Place vent foam strap beginning 1/2 inch proximal to the fibular notch/head, down the medial
side of the leg, continuing around the heel and ending on the lateral side opposite the start.
b. Place the edge of the elastic bandage on the malleolus and begin wrapping around the ankle
two rotations to secure the edge.
c. Fold down and hold excess ends of the vent foam strap while continuing to wrap the bandage
until the vent foam strap is completely covered and secure with clips.
NOTE: Depending on the size of the patient's leg a second elastic bandage may be necessary to
completely cover the vent foam strap.
d. Tape down the elastic bandage between the clips.
e. Remove the clips and dispose in trash receptacle.
f. Slide the spreader block between the vent foam strap and patient's foot.

13. Open and slide Buck's traction boot under injured leg to one inch distal to the fibular notch and
secure with straps.
CAUTION: When applying Buck's traction boot, assistance may be needed to lift leg and prevent
further injury to the patient. The Buck' s boot is available in small, medium and large.

14. Secure 18 inch single clamp bar to overhead traction bar proximal to the patient's injured knee.
15. Secure pulley attachment to the 18 inch single clamp bar in alignment with the injured knee.
16. Secure 9 inch single clamp (horizontally) to the crossbar at the foot of bed, medial to the injured
leg.
17. Secure 9 inch single clamp bar (horizontally) to the distal end of the 9 inch single clamp bar.

18. Secure center clamp bar vertically to the 9 inch single clamp bar in alignment to the leg.

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