Page 126 - ASOP Orthopedic Casting Manual

3.2 Types of Lower

Extremity Casts and

Splints - Overview

L2M Long Leg Cylinder Cast

A long leg cylinder c ast is an ex tended circumferential c ast from the proximal thigh to the ankle, without including
the foot. This c ast provides r igid suppor t for the knee and adjacent structures while allowing mobilit y of the foot
and ankle LBucholz et al., 2021M.

Indic ations

• Patella fractures (e.g., nondisplaced transverse fractures).
• Tibial plate au fractures (post-surgic al stabilization or conser vative management).
• Quadr iceps or p atellar tendon ruptures (post-surgic al immobilization).
• Severe ligamentous knee injur ies requir ing prolonged immobilization.

Applic ation Steps

1. Positioning: The p atient is placed supine with the knee in slight ex tension L5^10 degrees) to prevent stiffness.
2. Padding Applic ation: Apply stockinette and mul tiple layers of c ast p adding, with ex tra cushioning over the
p atella, fibular he ad, and tibial tuberosit y.
3. Cast Mater ial Applic ation: Apply fiberglass or plaster in circular layers, ensur ing proper molding around the
medial and lateral femoral condyles for structural suppor t.
4. Molding and Shaping: Maintain p atellar positioning and prevent excessive tightness by ensur ing even pressure
distr ibution.
5. Dr ying and Setting: Allow the mater ial to fully set and harden, which takes approximately 15 minutes for
fiberglass and up to 24 hours for plaster LBucholz et al., 2021M.
6. Follow-up Instructions: Educ ate the p atient on weight-be ar ing restr ictions, c ast c are, and signs of
neurovascular compromise (e.g., incre ased p ain, tingling, or swelling).