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AAOE Casting, Splinting and Soft Goods Program
Casting - Short Leg Walking Cast with Toe Plate
Casting - Short Leg Walking Cast with Toe Plate
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Video Transcription
Start wrapping the cast padding, beginning at the forefoot and moving out to the end of the toes. Make four to five turns at the toes for the bumper. And I do about five turns at the end, just because the weight bearing gives it a little bit more padding. Then begin to wrap up towards the knee using 50-50 coverage. Continue up the leg and make three turns at the top, just below the knee, for the bumper. For extra padding, place a double-layer strip of padding over the tibia. Then wrap padding over the strip. Take another double-layer strip of padding and place it under the foot like a stirrup. Then place a triple-layer strip at the back of the heel and beneath the foot, and wrap padding over the ankle and foot to cover the additional strips of padding. Begin applying the fiberglass at the middle of the foot and moving out to the toes. Making four to five layers at the end for strength, then moving back toward the ankle. Concentrate the first roll over the foot and ankle. You have to be very careful when you're wrapping this not to wrap the outer layers tighter than the under layers because that's when you get a wrinkle. So I usually grab the edges and pull it a little bit when I'm coming around just to make sure that doesn't happen. Use the second roll to continue up the leg and roll the fiberglass to within 1 inch of the padding. Cut two slits in the padding at the top and roll the stockinette down. And then fold these over. Be very careful not to pull that because it will wrinkle. You can cut excess stockinette off. Mold the cast while the fiberglass dries. Make sure to mold in the arch of the foot. You want to mold it into the arch. Make sure those toes aren't getting pulled in. You take a 4x15 splint and another roll of fiberglass. Start at the top and you roll down. Place the 4x15 splint at the back of the heel and bring it under the foot to the tip of the toes. Wrap the splint on with a 3-inch roll of fiberglass. You want to cut a slit here and a slit there so that that falls nicely. Trim the splint so it's even with the end of the cast and fold the stockinette over the toes. Mold the opening at the toes. Put your stockinette back, this is when you want to check for wrinkles, and then add your color roll. Finish with a final layer of fiberglass or colored roll. Mold the cast and ensure there are no wrinkles. And that is a short leg cast of toe plate. To remove the cast, use a marker to draw a line along the lateral side of the cast. Then draw another line on the medial side of the cast.
Video Summary
The video demonstrates how to apply a short leg cast with toe plate. Wrap cast padding from the forefoot to the toes, adding extra padding at the toes and end of the cast. Continue wrapping up towards the knee with 50-50 coverage. Place double-layer strips of padding over the tibia and under the foot, and a triple-layer strip at the back of the heel. Apply fiberglass layers, starting at the foot and moving towards the ankle, being careful not to wrap the outer layers tighter than the inner layers. Mold the cast while the fiberglass dries, paying attention to the arch of the foot and avoiding pulling on the toes. Use a splint and additional fiberglass to secure the heel and toes. Finish the cast with a final layer of fiberglass or colored roll. To remove the cast, draw lines on both sides for guidance.
Keywords
short leg cast
toe plate
cast padding
fiberglass layers
cast removal
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