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Splinting 101

Splinting 101. Carl Kaplan, MD Assistant Professor of Clinical Pediatrics and Emergency Medicine Stony Brook University School of Medicine. Overview. Basic principles Materials Types of splints Aftercare. Basic Principles. Indications

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Splinting 101

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  1. Splinting 101 • Carl Kaplan, MD • Assistant Professor of Clinical Pediatrics and Emergency Medicine • Stony Brook University School of Medicine

  2. Overview • Basic principles • Materials • Types of splints • Aftercare

  3. Basic Principles • Indications • Immobilization of acute orthopedic fractures or dislocations • Immobilization of ligamentous or tendinous injuries • Immobilization of wounds near mobile joints

  4. Basic Principles • Joint proximal/Joint distal immobilization • Avoid compartment syndrome • Avoid pressure necrosis • Properly address underlying wounds

  5. Materials • Cast padding (Webril) • Splinting material • Fiberglass, Plaster, Aluminum/Foam, etc... • Elastic wrap (ACE, Coban) • Shears • Cloth tape • Water (as needed for activation of certain materials) • Assistance

  6. Short Arm Splints • Hand - Position of function (neutral position) • 25-30 degrees wrist extension • 60-90 degrees MCP flexion • 10-30 degrees PIP flexion • 5-15 degrees DIP flexion

  7. Volar Splint • Indications • Single forearm bone buckle (torus) fracture • Multiple Metacarpal fractures • Wrist Sprain

  8. Radial Gutter Splint • Indications • 2nd or 3rd Metacarparpal fractures or dislocations • Significant 2nd or 3rd Proximal phalanx fractures • Known or suspected tendon injuries of 2nd or 3rd digits

  9. Ulnar gutter splint • Indications • 4th or 5th Metacarparpal fractures or dislocations • Significant 4th or 5th Proximal phalanx fractures • Known or suspected tendon injuries of 4th or 5th digits

  10. Gutter splints

  11. Thumb Spica splint • Indications • Thumb fractures or dislocations • Thumb sprains or tendon injuries • Suspected scaphoid (navicular) fractures

  12. Finger splints • Buddy Taping or Aluminum/Foam • Indications • Phalangeal fractures • PIP or DIP dislocations • Sprains • Tendon injuries (Aluminum/Foam only)

  13. Long Arm splints • Sugar Tong (ST) or Posterior (P) • Indications • Radius or Ulna fractures of forearm (ST) • Dislocations at wrist (ST) or elbow (P) • Distal humerus fractures (P)

  14. Sugar tong splint

  15. Posterior long arm splint

  16. Short leg splints • Indications • Select distal Tibia and Fibula fractures • High grade ankle sprains • Achilles tendon injuries • Mid-foot or metatarsal fractures

  17. Posterior Short Leg splint

  18. Stirrup or ‘U’ splint

  19. Combination short leg splint

  20. Posterior Long Leg splint • Indications • Tibia or Fibula fractures or dislocations • Patella fracture, dislocation, or tendon injuries • Distal Femur fractures

  21. Aftercare • Rest, Ice, Elevation (2-3 days) • Loosen splint if paresthesias or digital color changes develop • Analgesia • Crutches or Slings as indicated • Do not get wet • Arrange follow up

  22. Documentation (Fracture/ Dislocation Procedure *ED)

  23. Questions???

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