Double sugar tong splint

Background

• Better for most distal forearm and elbow fractures because limits flex/extension and pronation/supination

Indications

• Complex and unstable forearm and elbow fractures

Procedure

Splint Application General Procedure

• Assess pre-procedure neurovascular status (i.e., distal pulse, motor, and sensation)
• Measure and prepare the splinting material
  • May use contralateral extremity if easier
  • Most splints use a width slightly greater than the diameter of the limb
• Apply stockinette (if applicable)
  • Extend 2" beyond estimated the splinting material length
• Apply padding (if applicable)
  • Use 2–3 layers over the area to be splinted / between digits (when applicable)
  • Add an extra 2–3 layers over bony prominences
• Apply splinting material
  • Lightly moisten the splinting material.
  • Place as appropriate to specific splint type
  • Once finished, if applicable fold the ends of stockinette back over the splinting material if there is excess
• Apply elastic bandaging (e.g., ace wrap)
• While still wet
  • May further mold the splint to the desired shape
  • Maintain position until splint material has hardened
• Re-check and document repeat neurovascular status

Splint-Specific Details

• Apply padding and splint material as shown in figure
• Splint course:
  • First sugar tong from proximal palmar crease, around elbow, to dorsum of MCP joints
  • Second sugar tong from the deltoid insertion distally around the 90-degree flexed elbow, then proximally to 3 inches short of the axilla
• Key anatomic positions
  • Elbow at 90º
  • Forearm neutral with thumb pointed superiorly
  • Wrist should be maintained in slight extension (approximately 10-20°)

See Also

• Splinting