Page 127 - ASOP Orthopedic Casting Manual

3.2 Types of Lower Extremity Casts

and Splints - Overview

L3M Posterior Rigid Splint

A poster ior r igid splint is a non-circumferential immobilization device that suppor ts the lower ex tremit y while
allowing some degree of swelling. I t is commonly used in acute injur ies before definitive c asting to prevent
complic ations such as comp ar tment syndrome LEiff et al., 2020M.

Indic ations

• Acute fractures of the tibia, fibula, or ankle (pr ior to c asting).
• Severe ankle sprains (when swelling prevents immediate c asting).
• Achilles tendon ruptures (temporar y immobilization before surgic al inter vention).
• Postoperative immobilization in trauma c ases.

Applic ation Steps
1. Patient Positioning: Place the p atient supine with the knee slightly flexed and the ankle in neutral or
plantar flexion (for Achilles injur ies).
2. Padding Applic ation: Apply stockinette and c ast p adding along the poster ior lower leg, ensur ing thicker layers
over bony prominences.
3. Splint Mater ial Prep aration: Wet and activate fiberglass or plaster slabs, then apply along the poster ior aspect
of the leg ex tending from the proximal c alf to the metatarsal he ads.
4. Secur ing the Splint: Wrap the splint with elastic b andages LACE wrap) from distal to proximal, ensur ing
moderate compression without restr icting circulation.
5. Molding and Positioning: Adjust the ankle angle as necessar y, maintaining proper dorsiflexion for ankle
injur ies or slight plantar flexion for Achilles injur ies.
6. Dr ying and Setting: Allow the splint to set while monitor ing for signs of swelling, vascular compromise, or
discomfor t LEiff et al., 2020M.
7. Patient Educ ation: Instruct the p atient on splint c are, weight-be ar ing prec autions, and follow-up appointments
for re-evaluation or c asting.

Conclusion

Lower ex tremit y c asts and splints ser ve as essential tools for immobilizing fractures, ligament injur ies, and
postoperative conditions. Proper selection and applic ation of e ach device ensure optimal he aling, prevent
complic ations, and facilitate p atient recover y. Shor t leg c asts provide immobilization for foot and ankle injur ies,
long leg cylinder c asts stabilize knee injur ies, and poster ior r igid splints offer temporar y suppor t in acute trauma
c ases. He al thc are providers must adhere to proper c asting and splinting techniques to optimize outcomes and
prevent complic ations such as comp ar tment syndrome and c ast pressure sores LBucholz et al., 2021M.