How to Apply a Fiberglass Cast

Casting rolls

One of the most preferred non-surgical methods of immobilization of an extremity that has been injured, by a fracture, dislocation or soft tissue injury, is the cast. A cast is typically made of one of two materials, plaster or fiberglass. Fiberglass has rapidly become the preferred material due to its lighter weight and superior durability. Here are the essentials of application.

Things You'll Need

• Bucket of water Protective gloves Bandage scissors Fiberglass rolls Rolls of synthetic cotton padding Tube of lubricating jelly Second pair of hands, occasionally Motorized cast saw or scalpel blade (#10 preferred)

Instructions

1. 

   Understand that casting is as much an art as it is a science. While making sure specific techniques are adhered to, making the cast as presentable, protective and functional as possible are important goals as well. In order to apply a proper fitting and anatomically correct cast, you must first have a full understanding of the pathology that you are treating, and the ultimate goal of casting. Do you want to restore alignment? Or do you need to focus on general immobilization?

2. Understand that you will need to know what size of fiberglass rolls will allow for proper application. For example, you would not use a 6-inch roll of casting material on a forearm, or hand cast. It is too big and the risk of improper wrapping and wrinkles is high. It is also very difficult on the person applying the cast.

3. 

   Now that you know what body part requires a cast, you need an understanding of the necessary positioning of the affected extremity so as to apply the cast in a manner that will perform as intended. In the majority of cases, positioning the extremity in the "position of function," or the normal functional position versus the "anatomical position" is the preferred one because the patient can continue to use fingers and/or toes or ambulate more normally.

4. 

   Once the extremity has been placed in the position of function, it is important to maintain that position throughout the casting procedure. This can be accomplished by using various extremity holding devices, or merely a "second pair of hands." The cast should begin and end at the appropriate areas to avoid affecting mobility on adjacent parts, such as fingers, toes or upper/lower arm/leg areas.

5. Once the cast has been applied, it is important to "mold" or shape the cast to gently but firmly fit the shape of the extremity so as not to cause pressure sores or skin breakdown. Trim the ends of the cast to avoid sharp edges, and make sure that the cast has hardened completely before resting it on a pillow or other pad, to avoid causing dents in the cast, creating pressure areas.

Tips & Warnings

• Wrapping the cast and padding material too tight can occlude circulation. Pad bony prominences appropriately to avoid pressure areas.