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AAOE Casting, Splinting and Soft Goods Program
Casting - Thumb Spica Cast
Casting - Thumb Spica Cast
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Video Transcription
♪ Music Playing ♪ Thumb Spica Cast Place the arm in neutral position. Be careful not to ulnar deviate the arm. Cut a hole in the stockinette for the thumb and place the stockinette over the arm, from one to two inches past the fingertips to the elbow. Note that another option is to cut the thumb hole after placing the stockinette on the arm. Cut approximately three quarters of the way up a one inch stockinette and place it on the thumb. Apply cast padding. Start by wrapping around the wrist and then going through the web space of index finger and thumb. Go up and around the thumb three times. Make three turns around the hand for a bumper. Continue wrapping approximately down the arm using 50-50 coverage and staying within two fingers of the elbow unless otherwise instructed by the physician. Wrap three times around the index finger and thumb. Wrap three times around the end of the cast for a bumper. And then continue wrapping distally on the arm to ensure adequate padding and that the ulnar styloid is well padded. Make sure to keep 50-50 coverage of cast padding down the arm. Now we want to take our fiberglass. Keep the hand in neutral position Keep the hand and thumb in a C position as if holding a can. Apply fiberglass starting at wrist and working through the web space of the index finger and thumb. Use a fan fold at the back of the thumb if needed to add strength. Then wrap up and around the thumb three times before moving back down the wrist and arm. Leave one inch between the bumpers and the end of the fiberglass. Mold the cast. Use an interosseous mold, keeping the hand and thumb in a C position. Mold in the palm and maintain neutral position at the wrist. Remember to always use palms, never fingers. Fold the stockinette back at the tip of the thumb. Cut two slits opposite of each other in the distal end of the cast padding. Fold back the cast padding and stockinette. Smooth your stockinette down, and continue to keep your mold while it's drying. Cut two slits opposite of each other in proximal end of the cast padding. Fold back the cast padding and stockinette. Finish by wrapping with color roll. You want to get a good flat mold on the forearm and make sure that it's molded good into the palm. And that's the thumb speck of cast. To remove the cast, cut along the top and bottom of the cast, following the lines drawn in the video. As an alternate method, once you're more comfortable, you can cut along the side of the cast and then inside the thumb. Then, cut along the other side of the cast.
Video Summary
The video demonstrates how to apply a thumb spica cast. The process involves placing the arm in a neutral position, cutting a hole in the stockinette for the thumb, applying cast padding, and wrapping fiberglass around the wrist, thumb, and arm. The cast is then molded using an interosseous mold, and the stockinette is folded back. Finally, the cast is finished by wrapping it with color roll. To remove the cast, it can be cut along the top and bottom or along the sides and inside the thumb.
Keywords
thumb spica cast
applying cast
neutral position
fiberglass wrapping
cast removal
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