Ulnar gutter splint


  • Limits flexion/extension of the 4th/5th DIP, PIP, MCP, and wrist joints



Ulna Gutter 2.gif

Splint Application General Procedure

  • Assess pre-procedure neurovascular status (i.e., distal pulse, motor, and sensation) [1]
  • 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
    • Place padding between 4th and 5th digits to prevent maceration
  • Splint course:
    • Start at mid-forearm
    • Extend down ulnar aspect of forearm
    • End at mid-distal phalanx
      • Include the 4th and 5th digits
  • Key anatomic positions
    • Wrist slightly extended (10° to 20°)
    • 4th and 5th MCP at 50°
    • DIP/PIP in slight flexion (~5–10º)
    • Hand in position of function
    • Forearm in neutral position

See Also


  1. Splints and Casts: Indications and Methods. http://www.aafp.org/afp/2009/0901/p491.html Accessed April 5, 2017
  2. Chudnofsky C. Splinting Techniques.In:Roberts and Hedges’ Clinical Procedures in Emergency Medicine, Chapter 50, 999-1027.e1