Splinting: Difference between revisions

(36 intermediate revisions by 5 users not shown)
Line 1: Line 1:
==Types==
==Background==
{{Fracture management overview}}
 
==Splint Types==
*Hand
*Hand
**[[Buddy tape splint]]
**[[Buddy tape splint]]
**[[Finger splint]]
**[[Finger splint]]
*Arm
*Arm
**[[Double sugar tong splint]]
**[[Coaptation splint]]
**[[Forearm volar splint‎]]
**[[Forearm volar splint‎]]
**[[Long arm posterior splint]]
**[[Long arm posterior splint]]
Line 10: Line 13:
**[[Sling and swathe splint]]
**[[Sling and swathe splint]]
**[[Sugar tong splint]]
**[[Sugar tong splint]]
**[[Double sugar tong splint]]
**[[Thumb spica splint]]
**[[Thumb spica splint]]
**[[Ulnar gutter splint]]
**[[Ulnar gutter splint]]
*Leg
*Leg
**[[Long leg posterior splint]]
**[[Stirrup splint]]
**[[Stirrup splint]]
**[[Posterior ankle splint]]
**[[Posterior ankle splint]]
**[[Long leg posterior splint]]


==Upper Extremity==
==Splint Material==
===Humerus===
{| {{table}}
| align="center" style="background:#f0f0f0;"|'''Fracture'''
| align="center" style="background:#f0f0f0;"|'''Splint'''
| align="center" style="background:#f0f0f0;"|'''Disposition'''
|-
|[[Humeral shaft fracture]]
|{{Humerus shaft fracture splint}}
|
|-
|[[Supracondylar Humeral Fracture]]
|[[Long Arm Posterior Splint]]
|Ortho consult for Type 2 or 3
|-
|Humeral condyle fracture
|[[Long Arm Posterior Splint]]
|ortho for ORIF if displaced
|-
|[[Olecranon fracture]]
|
*Nondisplaced
**[[Sling and Swathe Splint]]
*Displaced
**[[Long Arm Posterior Splint]] or emerg. ORIF
|
|}


===Forearm===
*Stockinette <ref name="Principles of Casting and Splinting">Principles of Casting and Splinting
{| {{table}}
http://www.aafp.org/afp/2009/0101/p16.html
| align="center" style="background:#f0f0f0;"|'''Fracture'''
Accessed April 4, 2017</ref>
| align="center" style="background:#f0f0f0;"|'''Splint'''
**Cloth sleeve
| align="center" style="background:#f0f0f0;"|'''Disposition'''
**Base layer for splint/cast
|-
**Protects skin
|[[Radial head fracture]]
*Cast padding (eg Webril)
|
**Used with plaster of Paris
*Nondisplaced
**2-3 layers with padding of bony points as needed
**[[Sling and Swathe Splint]]
**Wrapping circumferentially with 50% overlap will automatically create 2 layers
*Displaced
*Plaster of Paris
**[[Long Arm Posterior Splint]] or emerg. ORIF
**6-10 layers for upper extremity splints, 12-15 for lower extremity splints
|
**Takes 20 minutes to cure, sooner if warmer water is used
|-
**Watch for exothermic reaction
|[[Monteggia fracture-dislocation]] (ulnar shaft w/prox radioulnar disloc)
*Elastic bandage
|
**Outer layer to hold splint in place
|Emergent ortho for ORIF
**Excessive tightness can lead to pain, less room for swelling
|-
|[[Galeazzi fracture]] (distal radius w/distal ulnar disloc)
|
|Emerg. ortho for ORIF
|-
|[[Elbow Dislocation]]
|[[Long arm posterior splint]] after reduction
|If associated fracture emergent ortho consult
|-
|[[Forearm fracture]]
|[[Sugar Tong Splint]]
|
|-
|[[Colle's fracture]] (distal radius with dist dorsal angulation)
|[[Sugar Tong Splint]]
|
|-
|[[Smith fracture]] (reverse colles w/ volar angulation)
|[[Sugar Tong Splint]]
|
|}


===Hand===
*Fiberglass
*Flexor tendon injury
**Pre-wrapped material
**[[Finger Splint]] + hand specialist ref.
**Use cool or room temperature water
*Extensor tendon injury
**Not as pliable as plaster of Paris
**Poss ED repair + [[Finger Splint]] to hand specialist
**Trim or cover cut edges to prevent injury
*[[Mallet Finger]]
**[[Finger Splint]] to DIP (DIP in slight hyperextension)
*[[Gamekeeper's Thumb]]
**[[Thumb Spica Splint]]
*[[Scaphoid Fracture]]
**[[Thumb Spica Splint]]
*Carpal Fracture
**[[Forearm Volar Splint|Volar Splint]]
*[[Bennet's Fracture]] (intrarticular Fx at base of 1st MCP)
**[[Thumb Spica Splint]]
*Rolando Fracture (comminuted base of 1st MCP)
**[[Thumb Spica Splint]]
*[[Boxer's Fracture]]
**[[Ulnar Gutter Splint]]
*MCP Fracture
**4th and 5th
***[[Ulnar Gutter Splint]]
**2nd and 3rd
***[[Radial Gutter Splint]]
*[[Finger (Phalanx) Fracture]]
**[[Finger Splint]] or [[Buddy Tape]]


==Lower Extremity==
==See Also==
*[[Vacuum splint]]


==References==
==References==
<references/>


[[Category:Ortho]]
[[Category:Orthopedics]]
[[Category:Procedures]]
[[Category:Procedures]]
[[Category:Sports Medicine]]

Revision as of 01:50, 10 May 2019

Background

Fracture management overview

Splint Types

Splint Material

  • Stockinette [1]
    • Cloth sleeve
    • Base layer for splint/cast
    • Protects skin
  • Cast padding (eg Webril)
    • Used with plaster of Paris
    • 2-3 layers with padding of bony points as needed
    • Wrapping circumferentially with 50% overlap will automatically create 2 layers
  • Plaster of Paris
    • 6-10 layers for upper extremity splints, 12-15 for lower extremity splints
    • Takes 20 minutes to cure, sooner if warmer water is used
    • Watch for exothermic reaction
  • Elastic bandage
    • Outer layer to hold splint in place
    • Excessive tightness can lead to pain, less room for swelling
  • Fiberglass
    • Pre-wrapped material
    • Use cool or room temperature water
    • Not as pliable as plaster of Paris
    • Trim or cover cut edges to prevent injury

See Also

References

  1. Principles of Casting and Splinting http://www.aafp.org/afp/2009/0101/p16.html Accessed April 4, 2017