Rolyan AquaForm Ankle Splint

Rolyan AquaForm Ankle Splint

  • FSA Approved

Rolyan AquaForm Ankle Splint has a zipper which provides a custom fit without bulk. This splint is custom-moldable to stabilize the ankle following surgery, fractures and soft tissue injuries or to follow the change in foot drop. Constructed of 1/8" (3.2mm) 1% perforated Aquaplast-T material provides a lightweight and effective splint.

Rolyan AquaForm Ankle Splint Features

  • Designed to be used with a cast shoe
  • Latex free
  • For size, measure circumference of ankle from calcaneum to lateral malleolus to dorsal ankle crease and back to calcaneum
  • Ships flat and must be fitted by a medical professiona


  • To stabilize the ankle joint
  • May be used following surgery, fractures, and soft tissue injuries

More Information

Instructions For Use:

1. The patient should sit with the ankle at 90° and the weight of the affected leg supported.
2. Place a piece of padding on the malleoli and the anterior side of the ankle joint. 3. Apply stockinette to cover the foot, lower leg, and knee. If softening the splint in a convection oven, use two layers of stockinette, with more over newly healed scars and skin grafts and sensitive skin.
Molding the splint
4. Heat the3.2mm Aquaplast*-T splint as follows:
Heat pan: Heat in water at a temperature of 160° to 170°F (70°C)to 75°C) for one minute or until transparent. Remove from heat pan at an angle to let water drain off without stretching the splint and place on a flat surface. Pat dry with a towel.
Convection oven: Heat without overlapping or folding on a baking sheet with a non-stick surface in an oven preheated to 195° to 205°F (90°C to 95°C) until transparent (softening may take up to 10 minutes). Remove from baking sheet and place on a flat surface. 5. Orient the splint against the sole of the foot, encircling the metatarsals, and with the zipper on the anterior surface of the leg (A).
6. Wrap the splint around the extremity. With the patient holding the proximal splint edge in position, fasten the zipper at the distal border of the splint and close the zipper. If necessary, gently pull the material evenly around the leg, from inside the splint toward the zipper.
7. Mold the splint over the extremity, paying special attention to areas of contour.
8. To avoid skin irritation, apply a small piece of padding under the end of the zipper while the splint cools.
9. A cast shoe can be used during ambulation. To ensure a close fit, place the cast shoe over the splint before it is cool.
10. Stroke the splint to mold it snug against the leg and leave it in place until it is completely cool. Continued stroking will help it maintain its shape.
Finishing the splint:
11. Remove the splint, stockinette, and padding from the patient. Pad the interior surface of the splint as needed.
12. The splint can be trimmed as necessary. The proximal zipper stop can be cut away and a new zipper stop formed as follows:
-Cut two small pieces of splinting material.
-To remove protective coating, apply solvent or scrape the surfaces to be bonded with a sharp tool.
-Lightly heat one of the pieces and the splint where the stop is needed. Be sure the areas are dry.
-Place the piece of splinting material onto the inside surface of the splint and stretch it, wrapping it around the edge of the splint.
-Smooth the new zipper stop inside the splint, and taper the edges.
-Repeat for the other side.
13. For greater comfort, self-adhesive padding can be applied to the proximal and distal borders of the splint after it is molded. Apply the padding first to the inner splint surface to minimize wrinkles between the splint and the skin. Any wrinkles that form can be cut away with scissors.
14. A properly applied ankle splint

Care And Cleaning:

  • The splint will lose its shape in temperatures over 135°F (57°C). It should be kept away from sources of heat such as ovens, hot water, open flames, and sunny car windows.
  • The splint may be cleaned with soap and lukewarm water. It should be allowed to air dry thoroughly before reapplication.


  • This splint is to be fitted initially by a healthcare professional who is familiar with the purpose for which it is prescribed. The healthcare professional is responsible for providing wearing instructions and precautions to other healthcare practitioners, care providers involved in the patients care, and the patient.
  • If unusual swelling, skin discoloration or discomfort occurs, use should be discontinued and a healthcare professional consulted.
  • The splint should fit snug enough to prevent migration, but not so tight that circulation is impaired.
  • After heating splinting material, always check its temperature before applying it to the patient.


  • Not for use over open wounds or infected areas
  • Not in the presence of severe edema
  • May not be recommended for the acute phase of fractures

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