|Application: The materials should be pre-prepared
to enable rapid application of the bandage. All the necessary materials should
be placed within reach to avoid hold-ups in the procedure.
The patient should be in a position which is comfortable to him/her and the
person applying the bandage. This may vary depending on the extent of the
injury, the diagnosis, the treatment method and the patient's condition.
Materials required: 1 x 5 cm and 1 x 7.5 cm Delta Cast Conformable polyester
support bandages and hydrogel-coated casting gloves, adhesive bandage, toweling
tubular bandage, self-adhesive fleece padding, bandage scissors, strapping,
velcro tape (e.g. Orthoplast T&C), felt-tip pen, approximately 2 cm wide
strip of X-ray film.
The toweling tubular bandage is slipped over the hand, forearm and upper
arm to protect the skin. To help with the cutting a narrow strip of unusable
X-ray film is inserted beforehand. The self-adhesive fleece padding is applied
to the basal thumb joint. In order to improve stability whilst maintaining
the flexibility of the cast in the elbow area, a cast strip of about 3 layers
produced from the 5 cm cast bandage is applied to the inner side.
Starting with the 5 cm cast bandage, 2 to 3 layers are wrapped around from
the hand joint upwards to the elbow. The 7.5 cm cast bandage is then wrapped
around as far as the shoulder. In order to optimize the fit and bonding of
the layers, the cast should be applied relatively tightly, extending it by
50% to 70%.
The cast is molded for approximately 4-6 minutes. The cutting lines are then
marked with a felt-tip pen. The cast is opened along the inserted strip of
X-ray film using the bandage scissors and trimmed for individual fit. A notch
is cut into the cast in the upper arm area in order to prevent movement of
the cut edges after re-application. A large part is cut out from the elbow
area to simplify the removal and re-application of the cast for checks and
makes it easier to examine the injury or carry out cold therapies. The cast
still retains its stability because of the longuette inserted on the inner
The fit of the cast on the patient is then checked. A dressing which has
been applied too tightly loosens by itself after opening.
If necessary, the cast can be additionally loosened by bending it open. The
cast is held in place with tape to suit the patient.
In order to produce an elbow brace from the finished upper arm cast, the
distal part of the cast is cut off using bandage scissors. The elbow brace
allows gentle rotation of the forearm whilst maintaining immobilization of
abduction and adduction. Velcro tape is best method of attaching it to the
An elbow brace can of course be produced direct. To do this, the cast is
applied as described above but not including the wrist.
The upper arm cast is attached using adhesive bandage taking into account
the state of the swelling. The small number of layers means that the cast
remains semi-flexible and can be adjusted depending on the individual state
of the swelling (looser or tighter). To do this, the adhesive bandage is
removed and the cast altered for a perfect fit. Re-application is carried
out as described above. This procedure can be repeated throughout the treatment