Spica cast application

Application of a 90 degree/90 degree spica cast.
(A) Generous padding is applied over the foot, and a pad is placed on the popliteal fossa to prevent injury to the peroneal nerve and popliteal vessels.
(B) A long leg cast is applied with the knee flexed 90 degrees. Longitudinal traction should NOT be applied while extending the long leg cast to the spica component to avoid the risk of an acute compartment syndrome.
(C) A mold is placed over the apex of the fracture, generally correcting a varus deformity into slight valgus.
(D) Using a standard spica table, the spica cast is applied with the hip flexed 90 degrees and abducted 30 degrees.