Maintain a neutral position of the wrist, with the elbow at 90 degrees, and the thumb in C position. Cut a slit in the stockinette for the thumb to pass through. Place the stockinette on the arm, from the tip of the fingers to 3 inches above the elbow. Keep the elbow bent at 90 degrees, and fold the stockinette in the anti-cubital space. Cut a slit 3 quarters of the way up a 1 inch stockinette, and place over the thumb. Start wrapping cast padding at the wrist, and wrap down toward the hand, coming high up on the back of the thumb. Wrap around the thumb to the tip about 3 times. Bring the padding around the hand for three turns for the bumper. Wrap the rest of the padding up the arm, covering 50-50 each time. Make sure you keep the elbow at 90 degrees. Continue with three turns around the arm, covering 50-50 each time. Continue with three turns around the top of the cast at the elbow for the bumper. Wrap the rest of the padding up the arm, covering 50-50 each time. Make sure you keep the elbow at 90 degrees. Continue with three turns around the top of the cast at the elbow for the bumper. Wrap back down for adequate padding. Use additional padding over the elbow to pad the bony prominence. So, we're going to take our 3x38 splint. Round the edges of the splint. Wet the splint and wring out as much water as possible. Place the splint around the volar side of the thumb and begin wrapping with cast padding. As you wrap, bring the splint down the volar side of the arm. Wrap around the back of the elbow and bring it out to the top of the hand. And then come up around the back of the elbow. Continue wrapping with cast padding to hold in place. And lay this on the back of the hand. Trim the top at the knuckle line and wrap the top. Cut darts in the splint at the elbow so that it folds down and does not wrinkle at the back. Wrap in place with cast padding. Continue to wrap up the arm to ensure adequate padding. Make two cuts on the padding. Fold the stockinette back at the thumb. Cut a small hole in the stockinette for the thumb. Turn back the stockinette over the hand. Mold the splint to form to the hand and press into the palm while keeping the thumb in a C position. Allow the splint to harden. Cut the padding back at the top of the crease of the elbow. Fold the padding back and turn the stockinette over the end. Finish by wrapping with elastic wrap or gauze at the elbow and wrap down to cover the hand and thumb one more time.

cast application

arm cast

thumb cast

wrist positioning

cast padding