Leg Splints

‍Inner: 
1. Stockinette 
2. Padding 

Middle: 
1. 10-12 layers of plaster or Fiberglass 

Outer:
1. Padding 
2. Elastic Bandaging 

Steps

1. Have the patient positioned with knee at 15 - 20 degree flexion with pillow or towels under the knee.
2. Measure the length of plaster/fiberglass to cut by starting at the gluteal fold to the base of the toes with the knee in 15 - 20 degree flexion .
3. If using fiberglass, allow an extra 2 cm of padding to overhang over the casting material to ensure soft edges. 
4. Apply stockinette to extend 5-10 cm beyond the splinting material over the leg. 
5. Apply padding layers over the stockinette in a circumferential pattern with 30 - 50% overlap of the preceding layer. 
6. Wet the plaster or fiberglass under water. If using plaster, squeeze out excess water to leave it moistened. 
7. Mold the long leg plaster/fiberglass at the gluteal folds-> heel -> base of the toes. 
8. Keep ankle in neutral at 90 degrees flexion.
9. If using plaster, apply an external layer of padding over the splint. 
10. Roll the stockinette over the splinting material.
11. Apply elastic bandaging in a circumferential pattern with 30 - 50% overlap of the preceding layer.
12. Mold the splint to have the ankle at neutral position and knee at 15 - 20 degrees of flexion.

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‍Inner: 
1. Stockinette 
2. Padding 

Middle: 
1. 10-12 layers of plaster or Fiberglass 

Outer:
1. Padding 
2. Elastic Bandaging 

Steps

1. Measure the length of plaster/fiberglass to cut by starting at the plantar surface of metatarsals -> heel -> level of the fibular head just below the knee. 
2. Measure the stirrup length of plaster/fiberglass by starting at the 3 cm below the fibular head lateral aspect -> heel -> same level on the medial aspect of proximal tibia. 
3. If using fiberglass, allow an extra 2 cm of padding to overhang over the casting material to ensure soft edges. 
4. Apply stockinette to extend 5-10 cm beyond the splinting material over the leg. 
5. Apply padding layers over the stockinette in a circumferential pattern with 30 - 50% overlap of the preceding layer. 
6. Wet the plaster or fiberglass under water. If using plaster, squeeze out excess water to leave it moistened. 
7. Mold the short leg plaster/fiberglass at the plantar surface of metatarsals -> heel -> level of the fibular head. 
8. Mold the stirrup plaster/fiberglass at 3 cm below the fibular head lateral aspect -> heel -> same level on the medial aspect of proximal tibia. 
9. Keep ankle in neutral at 90 degrees flexion unless it is an achilles injury 
10. If an Achilles injury, keep ankle plantar flexed at 20-30 degrees. (naturally at that angle if the leg is hanging off the table/bed)
11. If using plaster, apply an external layer of padding over the splint. 
12. Pull the stockinette over the splinting material.
13. Apply elastic bandaging in a circumferential pattern with 30 - 50% overlap of the preceding layer.
14. Mold the splint at neutral position or if it is an Achilles, at 20 - 30 degrees plantar flexion. 

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