Page 114 - ASOP Orthopedic Casting Manual

2.6 Thumb Spica Cast cont ...

Stockinette Applic ation
Me asure the stockinette: Me asure the length required for the stockinette, which should cover the
p atient's ar m from the upper ar m to the b ase of the thumb. Make sure you have enough mater ial to
fold b ack at the edges to cre ate a ne at f inish.

Cut the stockinette: Cut the stockinette to the me asured length, ensur ing it's wide enough to f it
comfor tabl y around the p atient's ar m without excessive stretching.

Position the p atient: Have the p atient sit or lie down in a comfor table position with their ar m well-
suppor ted and elevated. The f ingers should be slightl y flexed, and the thumb should be in a functional
position (slightl y abducted and ex tended ).

Appl y the stockinette: Slide the stockinette over the p atient's hand and up their ar m, ensur ing it
covers the entire are a where the c ast will be applied. Smooth out any wr inkles or folds.

Cre ate a thumb hole: Loc ate the b ase of the thumb and c arefull y cut a small hole in the stockinette for
the thumb to f it through. Make sure the hole is snug but not too tight, to avoid constr iction or
discomfor t.

Fit the thumb: Gentl y guide the p atient's thumb through the hole, ensur ing the stockinette covers the
b ase of the thumb and the thumb-foref inger web sp ace without any wr inkles or folds. The stockinette
should provide a smooth, comfor table layer bet ween the skin and the c ast p adding. Refer to video for
detailed instructions.

Padding Applic ation

Appl y p adding to the thumb: Begin appl ying the c ast p adding (cotton or synthetic) around the
p atient's thumb, star ting at the tip and wor king your way towards the b ase. Ensure adequate p adding
to prevent pressure sores, especiall y at the thumb's b ase and the thumb-foref inger web sp ace.

Appl y p adding to the wr ist and fore ar m: Star t wrapping the p adding around the wr ist, over lapping
e ach layer by 50% for unifor m thickness. Continue up the fore ar m, ensur ing the p adding lies smoothl y
without wr inkles or folds. Appl y ex tra p adding around bony prominences as needed.