Long arm posterior splint

Background

• Doesn’t completely eliminate supination / pronation
  • Either add an anterior splint or use a double sugar tong splint if complex or unstable distal forearm fracture

Indications

• Elbow and forearm injuries
  • Olecranon fracture
  • Distal humerus fracture
  • Both-bone forearm fracture
  • Unstable proximal radius or ulna fracture (sugar-tong better)

Procedure

Long arm posterior splint

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:
  • From proximal palmar crease along ulna
  • Following the ulnar forearm
  • Posterior side of flexed elbow
  • Posterior proximal arm (3 inches away from axilla)
• Key anatomic positions
  • Elbow at 90º
  • Forearm in neutral position with thumb up
  • Wrist neutral or slightly extended (10–20º)

See Also

• Splinting