Splinting: Difference between revisions
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==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]]
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**[[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 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
{| {{table}}
**Pre-wrapped material
| align="center" style="background:#f0f0f0;"|'''Fracture'''
**Use cool or room temperature water
| align="center" style="background:#f0f0f0;"|'''Splint'''
**Not as pliable as plaster of Paris
| align="center" style="background:#f0f0f0;"|'''Disposition'''
**Trim or cover cut edges to prevent injury
|-
|[[Hand and finger tendon injuries|Flexor tendon injury]]
|[[Finger Splint]]
|hand specialist referral
|-
|[[Hand and finger tendon injuries|Extensor tendon injury]]
|Poss ED repair + [[Finger Splint]]
|hand specialist referral
|-
|[[Mallet finger]]
|[[Finger Splint]] to DIP (DIP in slight hyperextension)
|
|-
|[[Metacarpophalangeal ulnar ligament rupture]] (Gamekeeper's thumb)
|[[Thumb Spica Splint]]
|
|-
|[[Scaphoid fracture]]
|[[Thumb Spica Splint]]
|
|-
|[[Carpal fracture]]
|[[Forearm Volar Splint|Volar Splint]]
|
|-
|[[Bennet's fracture]] (intrarticular fracture at base of 1st MCP)
|[[Thumb Spica Splint]]
|
|-
|[[Rolando's fracture]] (comminuted base of 1st MCP)
|[[Thumb Spica Splint]]
|
|-
|[[Boxer's fracture]]
|[[Ulnar Gutter Splint]]
|
|-
|4th and 5th [[MCP fracture]]
|[[Ulnar Gutter Splint]]
|
|-
|2nd and 3rd [[MCP fracture]]
|[[Radial Gutter Splint]]
|
|-
|[[Finger (Phalanx) Fracture]]
|[[Finger Splint]] or [[Buddy Tape]]
|
|}


==Lower Extremity==
==Pearls==
===Leg===
*Try to avoid large crinkles/folds with padding, can cause skin damage and breakdown
{| {{table}}
*Apply splint firmly but not too tight
| align="center" style="background:#f0f0f0;"|'''Fracture'''
**Allow room for anticipated swelling
| align="center" style="background:#f0f0f0;"|'''Splint'''
**Tight splint can lead to compartment syndrome
| align="center" style="background:#f0f0f0;"|'''Disposition'''
*Mold splint material with palms rather than fingers to prevent ridges, may be uncomfortable for patient
|-
|[[Tibial plateau fracture]]
|Knee immobilizer
|Ortho referral in 2-7d
|-
|[[Tibial shaft fracture]]
|[[Long leg posterior splint]]
|
|-
|[[Pilon Fracture]]
|[[Long leg posterior splint]]
|
|-
|[[Maisonneuve Fracture]]
|[[Long leg posterior splint]]
|
|-
|[[Ankle fracture]]
|[[Posterior ankle splint]]
|
|-
|[[Foot and toe fractures]]
|[[Posterior ankle splint]]
|
|}


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


===Foot and toe fractures===
==References==
{| {{table}}
<references/>
| align="center" style="background:#f0f0f0;"|'''Fracture'''
| align="center" style="background:#f0f0f0;"|'''Splint'''
| align="center" style="background:#f0f0f0;"|'''Disposition'''
|-
|[[Talus fracture]]
|[[Posterior ankle splint]]
|
|-
|[[Calcaneus fracture]]
|[[Posterior ankle splint]]
|
|-
|[[Lisfranc injury]]
||[[Posterior ankle splint]]
|
|-


==See Also==
*[[Fractures]]


==References==


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

Revision as of 17:14, 16 June 2021

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

Pearls

  • Try to avoid large crinkles/folds with padding, can cause skin damage and breakdown
  • Apply splint firmly but not too tight
    • Allow room for anticipated swelling
    • Tight splint can lead to compartment syndrome
  • Mold splint material with palms rather than fingers to prevent ridges, may be uncomfortable for patient

See Also

References

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