What should you do with wrinkled stockinette at the ankle when casting?

• A. Cut away excess wrinkled stockinette from the bend in the front of the ankle
• B. Leave wrinkled in place
• C. Remove all stockinette
• D. Double the wrinkled part

Answer: (A)

Wrinkles in padding under a cast create pressure points, especially over the ankle where the skin folds as the joint moves. The goal is a smooth, even layer of padding so the plaster distributes pressure evenly. At the front bend of the ankle, a wrinkled stockinette can become a high-pressure area once the cast is applied. Cutting away the excess wrinkled stockinette from that bend smooths the surface, reducing the risk of skin irritation or pressure sores and improving cast comfort and fit. Leaving wrinkles would push against the skin; removing all stockinette would erase padding; doubling the wrinkled part would make the problem worse. After trimming, check that the padding lies flat and evenly before applying the plaster.