Page 148 - ASOP Orthopedic Casting Manual

3.5.4 Long Leg Cast cont ...

Stockinette Applic ation
Applying a stockinette and p adding cor rectly is crucial for p atient comfor t and protection. Here is a step-by-step
guide on how to apply both the stockinette and p adding:
Prep are the mater ials: Gather the necessar y mater ials, including a stockinette, scissors, and c ast
p adding.

Choose a 4 inch wide stockinette, ensur ing it is wide enough to cover the entire leg without excessive
bunching.

Me asure the stockinette: Me asure a length of stockinette that ex tends at le ast 2]3 inches beyond the
anticip ated proximal (thigh) and distal ( lower leg) c ast edges. Cut the stockinette to the appropr iate
length.

Position the stockinette: Slide the stockinette over the leg, making sure it re aches from just below the
groin to just above the ankle joint.

Smooth out any wr inkles or folds to avoid pressure points inside the c ast.

Le ave ex tra length at both the proximal and distal ends to be folded over after p adding and f iberglass
applic ation.

Padding Applic ation
Choose 4-inch wide p adding rolls b ased on the size of the p atient ʼs limb. Appl y the f irst section
around the upper thigh - wrap the p adding circumferentiall y from proximal to distal, maintaining a
50% over lap with e ach p ass to ensure unifor m coverage.

For the nex t roll, continue over the knee joint and provide additional layers around the p atella and tibial
tuberosit y to prevent pressure sores.

Pad bony prominences thoroughl y: L1M Patella: Appl y ex tra p adding to distr ibute pressure; L2M Fibular
he ad: This are a is prone to ner ve compression (watch for signs of common perone al ner ve
compression); L3M Tibial tuberosit y & lateral cond yles: Reinforce with additional layers to prevent
discomfor t.

Ex tend p adding distall y to just above the ankle, stopping 2 inches above the malleoli (to prevent
excessive bulk ne ar the ankle joint).

Smooth out any wr inkles: As you appl y e ach layer of c ast p adding, make sure to smooth out any
wr inkles or folds to ensure a comfor table f it. Wr inkles or folds c an c ause discomfor t and may even
le ad to pressure sores.

Check for proper f it: After appl ying the c ast p adding, check to ensure that it is not too tight or too
loose. The p adding should provide cushioning and protection for the limb, but should not constr ict
blood flow or c ause discomfor t.