Preparation
Before application of any backslab or cast you should:
- Inspect skin for cuts/grazes
- Remove any limb jewellery
Summary
Step 1 - Stockinette
- Use appropriately sized stockinette - not be tight
- Start proximally beyond elbow crease to beyond MPJs
- Apply separate stockinette over thumb
Step 2 - Ortho Felt to bony prominces
Apply orthopaedic felt to:
- Ulnar styloid
- Base of thumb
Step 3 - Prep PoP & bandages
Plaster of Paris.
- Should measure from elbow crease to the MPJs
- 8 to 10 layers
- Cut ends to allow for fanning out
Conforming Bandages
- Prepare wet conforming bandage by dipping it in water
- One dry conforming bandage will also be required
Step 4 - Applic. of wool
- Use approx. ½ a roll of 10cm wool
- Apply gently
- Cover wool with 50% coverage over previous layer
Step 5 - Applic. of PoP
- Fan out to allow for 2/3 circumferential coverage
- Use warm (not hot) water
- Don't squeeze after wetting, allow water to drip off
- Cut away jagged edges that may protrude into arm/hand
- Apply the POP centred on the dorsal aspect of the forearm with 2/3 circumferential coverage
- Smoothen and laminate the POP by rubbing with flat palms
Step 6 - Applic. of Conforming bandages
- Apply the wet bandage first, gently without tension
- Cut bandage going through web space
- Turn stockinette back at ends before 2nd dry bandage
- The forearm is held with the elbow in a 90° flexed and the wrist in the position of function of 25° dorsiflexion
- Elbow should be free to flex and extend
- Thumb and fingers should be free at the metacarpo-phalangeal joints
- Apply light pressure with palms to help laminate layers