A method of constructing a total contact cast, that includes the steps of wrapping a lower leg with foam from above the malleoli to mid-calf, covering the foot and lower leg with stockinette covering the foot and ankle with cast padding, and applying cast tape to the leg over the previously-applied foam and allowing the cast tape to harden. A foam pad and lateral and medial malleolar pads are applied to the leg section of the cast and a foot and ankle positioning device is applied to the leg, and cast tape is applied over the lower leg and foot and allowing the cast tape to harden. A walking support is applied to the foot. A foot and ankle positioner for a total contact cast is also disclosed.
