We're going to put on a long leg walking cast. Place the stockinette on the leg as if you were doing a short leg cast, from just below the knee to about one inch past the toes. Make sure the patient's leg is positioned at a 90 degree angle. Work out all our wrinkles. Make sure our patient's at 90 degrees. Hold the stockinette at the front of the ankle and cut out the folded material. Start wrapping the cast padding mid-foot and working down to the end of the toes, using 50-50 coverage. Work three times around the toes before working your way back up the foot and leg. You don't have to worry about making a bumper at the top, since you'll be adding the rest of the long leg cast later. We do want to be sure we've got adequate padding. Place a double strip of padding along the tibia, then continue wrapping padding down the leg. Place a double strip of padding as a stirrup under the foot. And a triple for the heel. Place a triple strip of padding on the heel. Then continue wrapping down the leg. Make sure everything is nice and smooth. Check and make sure we're still at a 90 degree angle. And I usually stretch it out at the toes. Start wrapping the fiberglass. Begin by making three turns at the toes and then work your way up the leg. Right at the toes and work our way up the leg. Then, apply another layer of fiberglass, moving back down the leg. Cut out the fiberglass around the toes. Be sure not to cut out the padding underneath the foot. Then cut a slit on both sides of the padding so you can fold the padding and stockinette over. Make sure you cut far enough so the baby toe is not covered. But still supporting the metatarsal heads on the bottom. Be sure when you cut the bottom you don't cut your padding. Now I'm going to cut a slit up the padding and check and make sure we got good clearance on the baby toe. We do. Now since this is a walking cast, it needs to be reinforced and you also want to mold your arch good. The long leg walking cast requires a lot of reinforcement. You can reinforce the cast by adding another layer of fiberglass or with a pre-made splint. The method we will use is the splint. If you're using a splint, be sure and nick it so it folds down nicely. Trim the splint so that it's even with the bottom of the cast and then fold down the padding and stockinette. You have good support underneath but you have clearance on all the toes. Take your color roll and you can go ahead and finish the bottom. Apply a layer of the colored roll and mold the cast. You want to let the bottom part get good and dry before you move on up because if you prop the heel on something before it's dry you'll get a dent in the heel. That's the bottom portion. Okay, we're going to finish up our long leg walking and put a stockinette up the top. To complete the top of the cast, first place stockinette from the knee to the thigh. Start wrapping the cast padding where the bottom part of the cast ends and work your way up through the thigh. Make three turns at the top for the bumper before going back down the leg. And then come back down. Usually cover about 50-50, but you can kind of see where you need more padding. Place a couple extra strips of padding at the knee and then wrap them in. Make sure the knee isn't hyperextended at all. Start wrapping the fiberglass, overlapping the short leg cast to ensure strength. Then wrap up the leg. And then start wrapping up the leg. Go ahead and do your cuts at the top. Put the padding at the top so you can fold the padding and stockinette down. Remember, don't pull it. Use your color roll to finish out and you might need two color rolls depending on the length of the leg. Finish with a layer of colored roll, then mold the cast. And that's the longleg walking cast.

long leg walking cast

applying cast padding

fiberglass application

cast reinforcement

molding and drying cast