Authors of section


Daniel Green, Philip Henman, Mamoun Kremli

Executive Editor

James Hunter

General Editor

Fergal Monsell

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Short leg cast

1. General considerations

A below-knee cast or short leg splint provides additional stabilization and can be used following closed reduction or surgical fixation in the early postoperative period.

Short leg cast for immobilization of the ankle


  • Pressure sores
  • Skin irritation
  • Compartment syndrome
  • Thermal burns (avoid using hot water)


If severe swelling prevents application of a circumferential cast, a temporary splint may be applied as an alternative.

With the knee flexed, apply padding around the leg and slabs of casting material posteriorly, covering half of the circumference.

Secure the splint with an elastic bandage.

Application of a short leg splint

2. Material

  • Tubular bandage (stockinette) of appropriate size
  • Cast padding
  • Felt
  • Casting material: synthetic, plaster of Paris, or a combination of both
  • Water

The water temperature should ideally be between 22° and 25° C.

Material for cast application

3. Casting

Patient and leg positioning

Place the patient in a supine position with a bolster under the knee to keep it flexed.

An assistant supports the knee.

Patient and leg positioning for application of a short leg cast


The cast extends from just below the knee to the base of the toes.

Apply a tubular bandage and cut it slightly longer than the length of the final cast.

The assistant holds the toes, not the stockinette, with the ankle in a neutral position.

Dressing for short leg cast


Consider adding thick felt over the padding at the malleoli, tibial crest, heel, and the free edges of the cast.

Apply cast padding without creases, overlapping each layer by 50%.

Padding for short leg cast

Cast application

Apply the first layer of cast material and overlap each layer by 50%.

Avoid sharp edges at the ends of the cast. Make sure the upper end of the cast is well below the popliteal fossa.

Apply further layers of cast material to produce sufficient stability.

Cast application for short leg cast

Avoid pressure over the fibular head and neck by adding sufficient padding and shortening the cast to prevent injury to the peroneal nerve.

Avoiding pressure over the fibular head and neck with application of a short leg cast

Fold the tubular bandage and padding over the edges of the cast before applying the final layer of casting material.

Folding bandage and padding over the edges of a short leg cast
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