Splinting and Use of Crutches

1. Splinting and Use of Crutches

2. Emergency Emotional Care • Emergency care relative to emotional reactions to trauma must be provided • Accept rights to personal feelings • Show empathy, not pity • Accept injured person’s limitations as real • Accept own limitations as provider of first aid • Be calm

3. Emergency Splinting • Should always splint a suspected fracture before moving • Use proper immobilization to decrease risk of • Damage • Hemorrhage • Potential for death (if handled improperly) • Splint where athlete lies and avoid moving them • Splint one joint above and one below fracture

4. Rapid form immobilizer • Styrofoam chips sealed in airtight sleeve • Moldable with Velcro straps to secure • Air can be removed to make splint rigid • Air splint • Clear plastic splint inflated with air around affected part • Can be used for splinting but requires practice • Do not use if it will alter fracture deformity • Provides moderate pressure and can be x-rayed through • Half-ring splint • Used for femoral fractures • Requires extensive practice • Open fractures must be dressed appropriately to avoid contamination

5. Lower Limb Splinting • Foot and ankle require splinting of foot and knee • Knee, thigh, or hip require splinting of whole leg and one side of trunk • Upper Limb Splinting • Shoulder splinting is difficult • Use sling and swathe with upper limb bound to body • Upper arm and elbow • Splint with arm straight to lessen bone override • Lower arm and wrist • splint in position of forearm flexion and support with sling • Hand and finger • splint with tongue depressors, roller gauze and/or aluminum splints

6. Moving and Transporting Injured Athletes • Must be executed with techniques that will not result in additional injury • No excuse for poor handling • Planning is necessary and practice is essential • Additional equipment may be required

7. Proper Fit and Use of Crutches or Canes • When lower extremity ambulation is contraindicated • Faulty mechanics or improper fitting can result in additional injury or falls • Fitting athlete • Athlete should stand with good posture, in flat soled shoes • Crutches should be placed • 6” from outer margin of shoe • 2” in front of shoe • Crutch base should fall 1” below anterior fold of axilla (2 - 3 fingers) • Hand brace should be positioned to place elbow at 30 degrees of flexion • Cane measurement should be taken from height of greater trochanter

8. Walking with Cane or Crutch • Corresponds to walking • Tripod method • Swing through without injured limb making contact with ground • Four- point crutch gait • Foot and crutch on same side move forward simultaneously with weight bearing

9. Cane Tripod technique • Used on level surface • Modified with stair climbing • Unaffected support leg moves up one step (good goes up first) • Body weight is supported on crutch • Affected leg is pulled up to step • Reversed when descending stairs • Unaffected or good leg is used to lower • Affected leg and crutch (bad goes first) • Crutch walking follows a progression • Non-weight bearing (NWB) • Touch down weight bearing(TDWB) • Partial (PWB) • Full weight bearing (FWB) • When using cane or one crutch, support should be held on affected side