Indications:

• Fibular ligament rupture.
• Ligament strain of an ankle.
• Distorsion of the ankle.
• Avulsion of ligaments after distorsion.
• Weber A fracture.
• Positioning splint.
• Physio purposes.

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 7.5 cm Delta Cast Conformable polyester support bandage and hydrogel-coated casting gloves, toweling tubular bandage, self-adhesive fleece padding, adhesive bandage or velcro tape, bandage scissors, felt-tip pen.

Photo 1:
The toweling tubular bandage is applied to form a layer of padding underneath. A strip of fleece padding is inserted on the outer side to help with the cutting. A U-shaped section of fleece is applied to the ankle bones for additional padding.

Photo 2:
A 2-layer longuette is produced from the cast bandage and applied as a stirrup as shown. It may be of help if the patient holds the longuette firmly and pulls it upwards.

Photo 3:
The cast longuette is held in place using the remaining cast bandage (1 to 2 layers). The cast should be applied relatively tightly (extending it by about 50 to 70%). This helps to achieve the best fit and bonding of the layers. The cast is then molded to the foot and ankle joint for four to six minutes.

Photo 4:
Following the molding phase the cutting lines are marked and the cast opened on the outer side using bandage scissors. If the cast has been applied too tightly it will loosen by itself after opening (special feature of Delta Cast Conformable). The cast is removed and trimmed for individual fit. This involves cutting a large section out of the heel part making it easier to wear normal shoes. A narrow bridging section is left at the back to help with re-application and improve the comfort for the patient. It can be cut away at any time if necessary. In order to maintain unrestricted rotation movement for the foot, part of the cast is cut away on the outer side.

Photo 5:
The fit of the cast on the patient is then checked. A sole cast extending further along the area above the foot restricts rotation more so than a short and narrow bridging section. It can be shortened using bandage scissors at any time.

Photo 5a:
The rear view of the Ankle Brace shows how it is trimmed for individual fit.

Photo 6:
The Ankle Brace is fixed in place with an adhesive bandage or velcro tape taking into account the state of swelling. The patient can wear a cotton sock under the cast to improve the comfort. Normal shoes can be worn.
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 and re-applied using an adhesive bandage or velcro tape.

Combicast: Combination of ankle brace and metatarsalshoe.
This variant allows the plantar and dorsal flexion of the foot, while totally restricting the supination and pronation. (see metatarsalshoe). Here the cast is applied up to the base joints of the toes and then split dorsaly. The cast then gets cut to leave a plantar footplate that reaches to the end of the toes. In the area of the distal forefoot a 2 cm wide cast strip is kept.