false
Catalog
AAOE Casting, Splinting and Soft Goods Program
Casting - Ulna Gutter Cast
Casting - Ulna Gutter Cast
Back to course
[Please upgrade your browser to play this video content]
Video Transcription
Make sure the wrist is in a neutral position, and the fourth and fifth fingers are bent at a 90-degree angle. Cut a thumb hole on one side of the 2- or 3-inch stockinette. On the opposite side of the thumb hole, cut about 1 inch off the side of the stockinette to the end for the ulnar side. Note that another option is to cut the thumb hole after placing the stockinette on the arm. Place the stockinette over the arm and smooth out all wrinkles. Cut ¾ of the way up a 1-inch stockinette and place over the pinky and ring fingers. Begin wrapping the padding at the wrist. Remind your patient to keep their wrist back some. Wrap up through the hand. Wrap through the web space of the thumb and index finger and come up high on the lateral side of the hand. Wrap distally around the hand to include the pinky and ring fingers, ensuring that they do not overlap. Wrap about three times around these fingers to ensure adequate padding. Continue to wrap back through the web space of the index finger and thumb and then proximally down the arm using 50-50 coverage. Make three turns about two inches from the elbow, unless otherwise ordered by the physician, for the bumper. Come back down to make sure you have adequate padding everywhere. You may use a fiberglass splint or roll-out fiberglass to add additional strength. Cut the end of the splint to create a dip so that it molds around the fingers. Trim the other end of the splint to the appropriate length. Wet the splint and wring out as much water as possible. Place the splint on the ulnar side of the hand, around the fourth and fifth fingers. Wrap with a one- or two-inch fiberglass to hold in place. Make sure, as you are wrapping, that the patient is keeping their wrist back. I'm going to leave about an inch there at the end. Wrap with a second 2-inch fiberglass roll to anchor the splint. You can wrap as if you were doing a short arm cast. Mold the cast. Make sure the wrist is extended 30 degrees and the fingers are at 90 degrees. Use an interosseous mold for the arm. Then mold the hand, making sure to mold using your palm, not your fingertips. Fold down the stockinette on the pinky and ring fingers. Make sure there is enough room so that the fingers do not overlap. Make sure you have enough room so your fingers aren't twisting in together. Make small cuts on either side of middle and index fingers and fold back the stockinette. Continue to mold the cast using your palm. Make sure the stockinette remains smooth. Make two small cuts opposite of each other on the proximal end of the padding and fold the stockinette back over. Finish by wrapping with a color roll. With the color roll, if you come kind of across there and come high, it'll come right up to the fingers. Make sure you're not missing any spots with your color. I usually do use a tight moleskin padding right here just to make sure that finger doesn't rub the other finger after it's dry. And that is an ulna gutter cast. To remove the cast, cut along the top and bottom of the cast following the lines drawn in the video.
Video Summary
This video demonstrates how to apply and remove an ulna gutter cast. To apply the cast, ensure the wrist is in a neutral position and cut a thumb hole on one side of the stockinette. Place the stockinette over the arm and smooth out any wrinkles. Wrap padding around the wrist, hand, and fingers, making sure there is adequate coverage. Apply a fiberglass splint on the ulnar side of the hand, wrap it with fiberglass, and mold it to the desired shape. Fold down the stockinette on the pinky and ring fingers and make cuts to fold back the stockinette. Mold the cast using your palm, ensuring the stockinette remains smooth. Finish by wrapping with a color roll to secure the cast. To remove the cast, cut along the top and bottom following the lines drawn in the video.
Keywords
ulna gutter cast
apply cast
remove cast
wrist position
fiberglass splint
×
Please select your language
1
English