Posterior ankle splint

Background

• Also know as "Short-Leg Posterior Splint"
• Adding a coaptation splint (i.e., combining with an ankle stirrup splint) eliminates inversion / eversion
  • Especially useful for unstable fracture and sprains

Indications

• Distal tibia/fibula fracture
• Tarsal/metatarsal fracture
• Reduced ankle dislocation
• Severe ankle sprain
• Achilles tendon rupture (equinus position)

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
  • If patient can tolerate prone position and flexing knee to 90 degrees, it will help with placement
  • If combining with ankle stirrup splint, place posterior ankle splint first
• Splint course:
  • Start at plantar surface of the great toe or metatarsal heads
  • Extend along posterior lower leg
  • End 2-inches distal to the fibular head (to avoid compression of the common peroneal nerve)
• Key anatomic positions
  • Flex ankle to 90 degrees (unless Achilles tendon rupture)

See Also

• Splinting
• Ankle stirrup splint