fig1 is a front view of a patient &# 39 ; s leg dressed and ready for cast preparation . fig2 is a front view of a patient &# 39 ; s leg with the first protective initial leg cover . fig3 is a front view of a patient &# 39 ; s foot with proprietary toe protector , trimmed to fit contour of the foot . fig4 is a front detail view of a patient &# 39 ; s leg prepared with proprietary felt lateral and medial offloading and maleoli strips . fig5 is a right detail view of a patient &# 39 ; s leg in prone position , prepared for casting . fig6 is a right detail view of a patient &# 39 ; s leg with initial roll of elastic plaster casting material . fig7 is a right detail view of a patient &# 39 ; s leg with first roll of fiberglass that is wet and rolled to cover to just below fibular head . fig8 is a right detail view of a patient &# 39 ; s leg with the proprietary extra strength pre - fabricated splint . fig9 is a right detail view of a patient &# 39 ; s leg and foot with final roll of fiberglass securing proprietary rubber rocker walker . fig1 is a right detail view of a patient &# 39 ; s leg with finished cast . since other modifications and changes varied to fit particular operating requirements and environments will be apparent to those skilled in the art , the invention is not considered limited to the example chosen for purposes of disclosure , and covers all changes and modifications which do not constitute departures from the true spirit and scope of this invention . referring to the figures , in which like reference numbers refer to like components thereof , fig1 shows the foot of the patient covered by wound dressing 101 . fig1 is an example of a wound dressing application . a high percentage of diabetic and neuropathic patients will develop foot ulcerations . these patients have little or no feeling resulting in insufficient sensory feedback so they are unable to adjust the gait for the insensate foot causing tissue damage and ulcerations on the plantar surface . if these types of defects are left untreated they often require subsequent amputation of the limb . there is science based evidence that supports the methodology of offloading pressure from the wound removing the propulsive forces that stall the healing process . in the late 1930 &# 39 ; s a method of applying a rigid cast with little padding was introduced and was recognized as the “ gold standard ” for treating plantar surface ulcerations . there have been many concerns and issues relating to this modality that have led to underutilization amongst clinicians . the apparatus and method of the present invention addresses all of these concerns making the application more comprehensive , leading to faster wound healing times . in addition , the present invention accommodates deformities such as valgus , varus , equinus , and charcot foot which make up a large percentage of patients with plantar ulcerations . fig2 , illustrates a patients leg with the first layer 102 , is the first protective layer , consisting of a cotton tube stocking that covers the leg circumferentially allowing subsequent components to be attached . the cotton tube stocking covers above the knee distally and folded over the toes . fig3 , illustrates the patients leg with protective self - adhesive perforated foam toe pad . 103 , the self adhesive perforated foam toe pad 103 , is applied over the distal toe area to protect the toes from potential cast abrasions . the self - adhesive foam toe pad 103 , is perforated to allow air to moisture transfer keeping the toes dry reducing risk of maceration and fungal infection . the self - adhesive perforated foam toe pad 103 , is placed over the distal toes covering distal end of cotton tube stocking 102 , evenly distributing the perforated self adhesive foam toe pad 103 , over the dorsum to the plantar surfaces and is trimmed to fit the contour of the lateral and medial sides of the foot . fig4 , illustrates the patients leg with the self - adhesive felt lateral and medial strips 104 , secured from the proximal tibia just below the tibial tuberosity to the bottom of the malleolus attached to the cotton tube stocking 102 , with the self - adhesive felt maleoli strips 105 , overlapping the distal end of the self - adhesive felt lateral and medial strips 104 , connecting to the proximal edge of the self - adhesive perforated foam toe pad 103 . the proximal tibia is lined with a self - adhesive felt tibial crest bridge 106 , and distally with additional self adhesive felt strips 107 , to protect the tibial crest to the talus area of the foot . the unique configuration of felt strips protects all of the bony prominences that typically become pressure points , causing tissue degradation and additional ulcerations . traditionally a single wide protective strip is applied over the tibial crest and patches are applied over the malleolus . by utilizing self - adhesive felt lateral and medial strips 104 , and overlapping the self - adhesive felt maleoli strips 105 , more of the patient &# 39 ; s surface area is protected reducing the risk of additional ulcerations , also making the cast removal much easier and faster . fig5 , illustrates the patients leg in the prone position consisting of the cotton tube stocking 102 , self - adhesive perforated foam toe pad 103 , self - adhesive felt lateral and medial strips 104 , self - adhesive felt maleoli strips 105 , self - adhesive felt tibial bridge 106 , and self - adhesive felt tibial crest strips 107 . the patient is placed in the prone position as it reduces the incidence of toe - drop which can lead to improper cast application . it is important that the foot is secured in a ninety degree position for proper application and offloading . the present invention is unique as it removes in a bi - valve configuration meaning that the cast can be removed with a cast cutting saw by making parallel cuts on the lateral and medial sides of the leg and down the center of the self - adhesive felt lateral and medial strips 104 , which can be easily identified by the ridges on either side of the cast . cuts are then made distally across the self - adhesive lateral and medial maleoli strips 105 , and over the distal toe area . the center of the cast is pulled free allowing for the cast to easily be removed from the patient &# 39 ; s leg . fig6 , illustrates the patients leg in the prone position prepared for the first rigid layer after the felt and cast padding which is fine plaster or fiberglass 108 , casting material commonly referred to as the egg shell layer . the first plaster layer 108 , is the basis for intimate contact and is the layer that contours to the protective components . the first layer 108 , eliminates the risk of the protective felt strips floating and creating a pathway for shear forces that can lead to secondary ulcerations . fig7 , illustrates the patients leg in prone position , with the said first layer of a fiberglass 109 , applied over the said plaster 108 , and is applied by hydrating the material , rolling circumferentially from the distal edge of the plaster first layer 108 , up the leg to the proximal edge of the first plaster 108 . the said first fiberglass layer 109 , of casting material is applied providing strength to the cast . the cotton tube stocking 102 at the proximal end of the cast is left exposed so it can later be folded down to create a soft collar . fig8 , illustrates the patients leg in prone position and the multi - layer prefabricated support splint 110 , being applied over the said first fiberglass layer 109 . the multi - layer prefabricated support splint 110 , is applied between the said first fiberglass layer 109 , and the said second fiberglass layer 112 . the multi - layer prefabricated support splint 110 , is applied starting at the proximal edge of the posterior side of the cast , down the leg , across the plantar surface , overhanging at the toes and around the self - adhesive perforated foam toe pad 103 . the excess cotton tube stocking 102 , is rolled over the top of the multi - layer prefabricated support splint 110 , to secure it in place and create a soft collar around the proximal rim of the cast . the excess multi - layer prefabricated support splint 110 , material overhanging at the toes can be trimmed off in strips to level the rocker / walker 111 , accommodating patients with specific anatomic foot defects . traditionally a clinician will fabricate a splint by taking a fiberglass roll , unrolling it and folding it into approximately 3 layers . the present invention contains a multi - layer prefabricated support splint 110 , that is prefabricated and the equivalent thickness of two and a half traditional support splints adding significant structural integrity . the added strength of the support splint reduces the number of layers needed to cast a patient as well as application times . fig9 , illustrates the patients leg in the prone position with rocker / walker 111 , in position for attachment after said second fiberglass layer 112 . the rocker / walker 111 , is positioned with the front of the back walker pad in alignment with the anterior tibia of the leg and sitting directly on the prefabricated multi - layer support splint 110 . there is front to back orientation to the rocker / walker 111 , designed to promote normal bio - mechanics during ambulation . typically a cast utilizes a plate that lies on the plantar surface to accept the walker heel . the current invention has eliminated the walker plate by designing an extremely thick multi - layer prefabricated support splint 110 , that will accept the rocker / walker 111 . the said second layer of fiberglass 112 , is utilized to secure the rocker / walker 111 , while adding additional strength the cast . the said second layer of fiberglass 112 , is applied by hydrating the material , starting at the styloid process distally around the toes , circling the heel and back around until fiberglass overlaps . when adjacent to the metatarsal head the fiberglass is rolled circumferentially over the dorsum , securing the loose end of the multi - layer prefabricated support splint 110 , than pinning the front of the rocker / walker 111 circumferentially around the foot and twisting the fiberglass to create a rope effect , running through the rocker / walker 111 , center , around the heel securing the back of the rocker / walker 111 , and proximally up the leg to the edge of the cotton tube stocking 102 . the elimination of the traditional walker plate lowers the length of limb or cast length significantly and promotes normal ambulation . fig1 , illustrates the patients leg in the prone position with the completed cast ready to receive the said self adhering dressing 113 , to finish the cast . the self adhering dressing 113 , is utilized to secure the loose end of said second fiberglass layer 112 , starting at the edge of the said cotton tube stocking 102 , rolling distally towards the said rocker / walker 111 , until roll is utilized . having thus described the invention , what is desired to be protected by letters patent is presented in the subsequently appended claims .
a system that is clinically and effically sound , consisting of proprietary components that not only address the needs of the clinician but are universally utilized in a concise protocol covering a wide range of indications and conditions .