- The patient should be lying down on their back or front.
- If lying on their back, the knee should be supported.
- It is important to be aware that this starting position means extra attention should be paid to the correct joint position.
- In the case of an ankle sprain, any provisional compression bandaging should be removed and a new compression bandage should be applied.
Material
- Stockinette; select the appropriate size.
- Synthetic wadding.
- Plaster rolls; select the appropriate width, to enable a half-cylinder to be formed; remove the plaster rolls from the packaging.
- Absorbent bandage, to fix the plaster.
- Crepe bandage or cambric bandage to finish off (if necessary).
- Bandage scissors.
- Bandage hook fasteners or plasters.
Procedure
- Fill a small bucket with lukewarm water (around 20° C) and place this as close to the treatment table as possible.
- Ask the patient to lie on their back on the bench with their knee and ankle in 90° of flexion.
- If a compression bandage has been applied, a layer of padding is only required at points where the plaster may exert pressure (for example, the calf). In other cases, a stockinette and a layer of padding should be applied [Figure 130].
Figure 130
- Partially unroll the plaster layer and determine the length of the splint by holding it against the lower leg and the foot.
- Fold the unrolled plaster bandage into 5 to 6 layers. If using pure plaster of Paris, 10 to 12 layers will be necessary.
- Cut away a bit of the plaster bandage for the ankle.
- Fold the plaster layers in a concertina fashion and sub-merge them briefly under water.
- If the plaster is held under water at an angle, a few seconds will be sufficient.
- Remove the plaster bandage from the water and gently squeeze out any excess water.
- Stretch out the plaster splint and place it along the length of the calf [Figure 131].
Figure 131
- Make sure that the ankle remains in 90° flexion during moulding (for injuries involving the lateral ligaments, the ankle should also be immobilised in slight eversion) [Figure 132].
Figure 132
- Avoid making any indentations with your fingers (be mindful of the risk of pressure necrosis).
- Apply a wet absorbent roller bandage over the wet, moulded plaster [Figure 133].
Figure 133
- Ensure that the joint is maintained in the correct position until the plaster has hardened.
- Inform the patient that heat will be given off during the hardening process.
- Instruct the patient to keep the injured leg elevated for another 1 to 2 days.
- If necessary, they can walk using crutches as long as no weight is placed on the leg.
- Ask the patient to inform you immediately if the toes on the immobilised leg turn blue or pale.
- Instruct the patient to regularly move their toes [Figure 134].
Figure 134