Orthopedics Book


Short Leg Cast

Aka: Short Leg Cast, Short Leg Walking Cast
  1. Indications
    1. Third degree Ankle Sprain
    2. Distal non-displaced tibia Fracture or fibula Fracture
    3. Fifth Metatarsal Fracture at base
  2. Contraindications
    1. Mortis Fracture at ankle
  3. Images
    1. OrthoFootShortLegCast.png
    2. OrthoFootShortLegCastWithExtension.png
  4. Technique
    1. Apply Stockinette
      1. Cut stockinette long enough for patient to reach
      2. Patient can assist procedure by pulling stockinette
        1. Dorsiflexes foot to maintain functional position
    2. Determine landmarks of Casting
      1. Start of cast
        1. Cast to tibial tuberosity
        2. Avoid apply cast too high posteriorly
          1. Results in irritation to popliteal space
      2. End of cast
        1. Cast to first Metatarsal heads
        2. Tips of all toes should be clearly visible
    3. Apply padding (web-roll)
      1. Apply padding evenly to prepare all areas to cast
      2. Apply additional padding to high pressure areas
        1. Tibial tuberosity
        2. Base of foot
    4. Apply fiberglass material
      1. Pearls
        1. Apply fiberglass loosely
          1. Gently and smoothly roll to avoid constriction
        2. Use 3" fiberglass at foot
        3. Apply additional layering underlying sole of foot
        4. Use with Cast Boot only!
      2. First layer
        1. Apply without wetting fiberglass
        2. Roll smoothly over length of padding
        3. Fold stockinette over top of first layer
      3. Subsequent layers
        1. Apply wet
    5. Modification: Toe plate extension
      1. Indications
        1. Toe immobilization
      2. Technique
        1. Extend the cast beyond the distal toes
        2. Mold medial longitudinal arch with ankle at 90 degrees

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