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Casting Guide
DYNAMIC ORTHOSIS CASTING PROCEDURES
1
MATERIALS
  • Ink pencil
  • Tube or cut-down strip
  • Masking tape
  • Gloves
  • Flexible Fiberglass casting tape
  • Stockinette
  • Casting plates
  • Cast scissors or cast saw
  • Bandage scissors
  • Warm water
  • Plasticine or clay
  • Casting wedges (extrinsic posting)
2
REMOVING THE IMPRESSION
  • General examination of the patient’s extremity (see fig. 1)
  • Evaluate ROM (rigid or correctible)
  • Evaluate patient’s gait pattern (if possible)
  • Evaluate patient’s extremity non-weightbearing
3
CASTING PLATE SELECTION
  • Select correct casting plate size or fabricate one using wood and plaster
  • Check appropriateness of plantar arches (see fig. 2)
  • Check positioning of metatarsal pad
  • Check for location of toe-rise modifications (see fig. 3)
  • Check length of plate on foot
  • Make necessary adjustments using plasticine to build up areas
IF NO CASTING PLATE
  • If no casting plate is used, follow same procedures for casting as outlined
  • Provide tracing of foot
  • Mark the apex of the 1st and 5th metatarsal heads on the tracing
4
PREPARE FOR CASTING
  • Apply two layers of stockinette to the extremity
  • Apply masking tape to hold
  • Apply casting plate and hold in position with tape (see fig. 4)
  • Apply cut down strip over the dorsum of the leg and hold down with tape (see fig. 5)
  • Mark the following landmarks on the medial side. (see fig. 6)
    1. Medial malleolus
    2. First metatarsal head
    3. Navicular bone
  • Mark the following landmarks on the lateral side. (see fig. 7)
    1. Fibular head
    2. Base of the 5th Metatarsal
    3. Lateral malleolus
    4. 5th metatarsal head
    5. Peroneal notch
5
APPLYING THE CAST
  • We recommend using flexible fiberglass casting tape but plaster bandage or fiberglass tape are also an option
  • Submerge the bandage in water and squeeze out excessive material with your hand
  • Unroll the bandage without stretching it starting at the heel
  • Cover the entire foot using as many rolls as necessary (see fig. 8)
  • Place the foot on a flat, hard surface with knee at 90° and hip at 90° if possible
  • Maintain the foot in approximately 3 degrees or dorsiflexion (ideal position) if possible
  • Correct the foot to STN using one hand while you hold the leg in position with the other (see fig. 9)
  • Align the foot in relation to the leg
  • Apply pressure with your thumb on the area of the navicular and with the index finger on the talus to bring the calcaneus into a vertical position (STN assumed)
  • Hold this alignment until the cast hardens
6
REMOVING THE IMPRESSION
  • Using a cast saw or cast scissors, slowly and carefully cut the bandage along the buffer strip
  • Pay special attention to the area of the dorsum
  • Carefully open the front of the cast to prevent any deformation of the mold
  • Remove the buffer strip
  • Cut the stockinette using bandage scissors
  • Open the front of the cast and carefully remove the foot (see fig.10)
  • Quickly close the mold to prevent any deformity
  • Label your cast with the patient’s name and date
  • Complete the corresponding Solar System order form and include with your order