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1. Soap the hand and forearm generously using a cream soap (i.e. Dove).

2. Rest the elbow on a table. To ensure a good web space and well defined palmar arches, oppose the thumb to the long finger. The wrist is usually positioned in slight ulnar deviation and extension (Fig.A)

3. Cut three thickness of plaster for the palmar aspect and three for the dorsum of the hand and forearm. These should extend from the PIP joints to 2" distal to the elbow.

4. Cut a notch in the three palmar pieces to allow for the thumb (Fig. B)
5. Cut two lengths of plaster the length of the forearm. Fold both of these in thirds. These will be used for the thumbs (Fig. B)
6. Wet the dorsal pieces and apply to the forearm. Fold back only the radial or thumb side by 1/4" (Fig. C)
7. Wet the palmar pieces and apply. Smooth well and fold back only the radial edge where it meets the dorsal plaster. Allow the ulnar side to overlap the dorsal plaster.
8. Wet one of the thumb pieces and add to the dorsal slab (Fig. E). Fold back the edges and mould well in the web space.
9. Wet and add the last thumb piece to the palmar slab. Fold back the edges where it meets with the dorsal thumb piece.
10. Score across the seam with a pencil.
11. Gently pry the radial seam open and slide the hand out.
12. Approximate the seam using your pencil lines as a guide. Join with a double layer of plaster bandage (Fig. F)
13. Put the plaster cast in a box with enough padding to ensure it won't be crushed and mail with the completed order form, payment and Dr.'s prescription to: