# Providence® Orthosis Casting Procedure

Below are the casting instructions for the Providence® Nocturnal Scoliosis brace for orthotists.

## Two Piece Plaster Only Casting

**Step 1.**

• Apply tight tube stockinette

• Mark ASIS, Costal Margin, Illiac Crest, Trochanters, Sternal notch with indelible marker

• Take measurements according to ST Scoliosis Form

**Step 2.**

• Use 4 ply plaster splints vertically

• Cover all boney landmarks

• Extend past midline laterally

**Step 3.**

• Lock splints together with plaster roll applied horizontally

**Step 4.**

• Massage plaster until smooth

• Mold in slightly above iliac crest and below 12th rib - (waist)

**Step 5.**

• After anterior hardens roll patient to prone position with anterior cast in place

• Use parting agent (soap) laterally so posterior half doesn’t adhere to anterior

• Mark landmarks coccyx, inferior angle of scapula

**Step 6.**

• Use 3 ply plaster splints starting laterally, overlapping anterior section

• Cover landmarks

**Step 7.**

• Lock splints together with plaster roll applied horizontally

**Step 8.**

• Let plaster harden

• Separate posterior section from anterior

• Roll patient, take off anterior section

### One Piece Plaster/Fiberglass/Synthetic Casting

**Step 1.**

• Apply tight tube stockinette with cut strip anteriorly

• Mark ASIS, Coastal Margin, Illiac Crest, Trochanters, Sternal Notch with indelible marker

**Step 2.**

• Apply synthetic wrapping

• Cover all boney landmarks

**Step 3.**

• While wrap is drying, lay patient down on back with hips flexed slightly to reduce lordosis

• Let wrap harden

**Step 4.**

• Mark key lines horizontally across cut strip

• Cut wrap on cut strip

**Step 5.**

• Remove cast carefully, minimizing distortion

####  Related Articles 

#####  [Why Nocturnal Bracing Changes Everything](https://spinaltech.com/resources/why-nocturnal-bracing-changes-everything) 

#####  [The Winning Combination: Providence Nocturnal Scoliosis® Orthosis + stWear® Compliance Monitor](https://spinaltech.com/resources/providence-brace-stwear-compliance-monitoring-system-success) 

#####  [A Technical Perspective](https://spinaltech.com/resources/a-technical-perspective-on-nocturnal-bracing-for-adolescent-idiopathic-scoliosis)