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This overview of splinting covers basic principles, materials, types of splints, and aftercare. Learn about indications, immobilization techniques, and the proper address of underlying wounds.
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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 • Immobilization of acute orthopedic fractures or dislocations • Immobilization of ligamentous or tendinous injuries • Immobilization of wounds near mobile joints
Basic Principles • Joint proximal/Joint distal immobilization • Avoid compartment syndrome • Avoid pressure necrosis • Properly address underlying wounds
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
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
Volar Splint • Indications • Single forearm bone buckle (torus) fracture • Multiple Metacarpal fractures • Wrist Sprain
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
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
Thumb Spica splint • Indications • Thumb fractures or dislocations • Thumb sprains or tendon injuries • Suspected scaphoid (navicular) fractures
Finger splints • Buddy Taping or Aluminum/Foam • Indications • Phalangeal fractures • PIP or DIP dislocations • Sprains • Tendon injuries (Aluminum/Foam only)
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)
Short leg splints • Indications • Select distal Tibia and Fibula fractures • High grade ankle sprains • Achilles tendon injuries • Mid-foot or metatarsal fractures
Posterior Long Leg splint • Indications • Tibia or Fibula fractures or dislocations • Patella fracture, dislocation, or tendon injuries • Distal Femur fractures
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