Page 125 - ASOP Orthopedic Casting Manual

3.2 Types of Lower

Extremity Casts and

Splints - Overview

L1M Short Leg Cast

A shor t leg c ast LSLC) is a circumferential immobilization device that ex tends from just below the tibial tuberosit y
to the metatarsophalange al joints, le aving the toes exposed. This c ast is pr imar ily used to manage fractures,
ligamentous injur ies, and postoperative immobilization in the lower leg, ankle, and foot LEiff et al., 2020M.

Indic ations

• Distal tibia and fibula fractures (e.g., nondisplaced distal tibial shaft fractures, isolated fibular fractures).
• Ankle fractures and severe sprains (e.g., lateral malleolus fractures, stable bimalleolar fractures, high-grade
ligament sprains).
• Metatarsal and tarsal injur ies (e.g., nondisplaced fractures of the metatarsals, Lisfranc injur ies).
• Postoperative immobilization following foot or ankle surger y.

Applic ation Steps

1. Patient Prep aration: Position the p atient supine with the knee slightly flexed and the foot at 90 degrees neutral
dorsiflexion to prevent equinus defor mit y.
2. Padding Applic ation: Apply a layer of stockinette from the toes to just below the knee, followed by mul tiple
layers of c ast p adding ensur ing adequate protection over bony prominences (e.g., malleoli, heel,
and anter ior tibial crest).
3. Applic ation Fiberglass: Apply a thin layer of plaster or fiberglass c asting mater ial circumferentially, molding it
for optimal contour and suppor t.
4. Positioning and Molding: Ensure the ankle remains at 90 degrees to maintain neutral alignment while molding
the c ast.
5. Setting/Dr ying and Hardening: Allow the c ast to dr y fully, which takes 10^15 minutes for fiberglass and up to
24 hours for plaster LEiff et al., 2020M.
6. Post-Applic ation Care: Check for adequate circulation, sensation, and motion LCSM) and educ ate the p atient
on c ast c are and war ning signs of complic ations (e.g., p ain, swelling, numbness).