# Robert Jones Bandage Application

## Overview

This module describes how to apply a Robert Jones bandage, which is a bulky compression bandage usually applied to the lower limb to aid immobilisation and reduce swelling.

## Indications

1. Temporising measure for lower limb injuries

2. Ligamentous injuries to the knee

3. Occasionally for sprained ankles

## Contraindications

1. This bandage is not a definitive treatment for fractures

2. Very unstable knee injury or dislocation — use a back slab or cast before referral

## Patient information and consent

Always verify your patient’s identity and obtain informed consent before proceeding.

### How do I explain this procedure?

“Because you have hurt your leg, I’m going to apply a bandage that will help with the swelling and will keep it from moving too much.”

### What can my patient expect?

“I’m going to wrap your leg in a few layers of bandages. They will be quite tight so it might be a little uncomfortable, especially while I’m moving your leg around to wrap the bandages.”

### What is my patient’s role?

“Let me know if it becomes too painful. If you feel tingling in your leg or can’t move your toes anymore, or if your leg changes colour, call the nursing staff and we will remove the bandage.”

## Preparation

Prepare a trolley with equipment. An assistant is useful for this procedure.

### Documentation

1. Patient notes

### Equipment

1. Alcohol-based hand rub

2. Three rolls of elastic crêpe bandage

3. Three rolls of orthopaedic padding (OrthoWool)

4. Adhesive tape

## Site & Positioning

The patient should be supine or seated. The bandage is applied from mid-thigh to mid-calf.

## Procedure

Follow medical asepsis without gloves.

1. Perform hand hygiene.

2. Wind orthopaedic padding around the injured limb, starting from the mid-calf to the mid-thigh. Overlap each wrap 50%.

3. Wind a layer of elastic crêpe bandage over the padding, applying the same principle. Wind firmly but not tightly.

4. Repeat steps 2-3 until 3 layers of padding and crêpe have been applied.

5. Secure the end of the last layer with adhesive tape.

6. Examine the injured limb. Look for swelling distal to the bandage, assess the neurological function, check the pulses and the capillary refill time.

7. Dispose of medical waste safely.

8. Record completion of the procedure in patient notes.

## Risks

1. Constriction of the leg with potential tissue or limb loss

2. Nerve compression

3. Swelling

4. Deep vein thrombosis

## References

1. Stellenbosch University. General Principles of Casting. Available from: http://www0.sun.ac.za/ortho/webct-ortho/general/gips/Index-basics.html?