Step 1:
Determine that the casting container is of the correct size by first inserting the patient's hand into the empty container.
   a. Be sure the patient's hand is in the correct position. Fingertips are approximately 3/8 inch apart and slightly curled. Position thumb so that it is aligned with the index finger when viewed from the palmar side of the hand. Have the patient practice this hand position a few times before attempting the casting.
   b. Hand should not touch the bottom of any side of the container. Leave a minimum of ½ inch clearance all around. Height of the container should be a minimum of 3 inches above the styloid.

Step 2:
To mix Flexinate material, fill ½ gallon container with cold water, add Flexinate (approximately 1 lb. will fill the half-gallon mixing bowl) to water while mixing vigorously with hand or wire whip until a creamy batter results, usually in about one minute. Batter will be about the consistency of thick pancake batter. (See B & C.)

Step 3:
Immediately fill the casting container with about 1/3 of the Flexinate batter. Insert patient's hand (in correct position). Hold hand steady in this position and then quickly fill container to within ½ inch of the brim of the container with the balance of the batter. From beginning of mixing time to set-up time is approximately 4 minutes. (See D.)

Step 4:
Keep hand in the container of Flexinate for 5 minutes after Flexinate hardens.

Step 5:
Extract the hand by having patient "wiggle" his arm and fingers slightly as you pour about 1 cup of cold water around the wrist and top of the container so that it penetrates between the skin and the Flexinate. A gentle moving action with water will help "break the seal" between the Flexinate and the skin. When the water reaches the fingertips, the patient should then begin to slowly extract his hand as in removing it from a glove. Be careful not to tear the Flexinate material.

Step 6:
When the hand is removed, gently fill the resulting negative cast with cold water. Swish the water around in the cavity then empty it. Repeat several times.

Step 7:
Immediately mix approximately 2 lbs. of Stone in a clean mixing bowl, adding water slowly until a creamy batter results.

Step 8:
Pour about 1½ cups of this into the negative cast. "Swish" it around gently. Now slowly fill the entire cast to the top. While filling the cast, jolt the container gently on the bench top a few times to be sure the finger cavities are being filled. (See E.)

Caution: Do not use any reinforcing rods in the cast. This is unnecessary and can cause breakage of the cast.

Step 9:
Allow stone to set for 2 hours. Remove Flexinate from the hardened stone positive. Gently peel from the wrist of the cast toward the fingers (use extreme care to avoid breaking the fingers). A dull knife can be used to cut away the Flexinate, if needed. Allow this positive cast to set overnight. (See F & G.)

Step 10:
Identify each cast with the patient's name and your company name with a marking pen.

Step 11:
Repeat the above procedures to produce a cast of the opposite hand. Place each cast in a separate plastic bag, then pack carefully and ship.
Do not pack in a manner that will allow the two casts to contact each other during shipment.