Splints are generally used as a temporary method of immobilization.
Indications for splinting include fractures, dislocations, sprains, tendon and ligament partial or complete disruptions, joint infections, tenosynovitis, and lacerations.
Equipment needed includes:
Plaster or fiberglass
Bucket + water
Scissors or trauma sheers
Tips for application of the splint include:
Make sure to always use two to three layers of padding prior to placement of the splint.
Be sure to add extra layers of padding over bony prominences such as elbows and ankles, between digits and at each end of the splint border.
Do not tighten as it can cause ischemia.
May use plaster or fiberglass material to make a splint.
Plaster should be used anytime that it is essential to help maintain stability of the bone or joint, that is, after any reduction is performed or for any potentially unstable fracture.
Generally, eight to ten layers of plaster are needed for upper extremity splints, and twelve to fifteen layers of plaster are needed for lower extremity splints.
As plaster dries it creates an exothermic reaction.
The more layers used increases the risk of burns.
Plaster may take up to twenty-four hours to fully cure.
Fiberglass is easier to use and more breathable, but is less moldable and therefore does not offer as much stability as a plaster splint.
Cures in approximately 20 minutes.
Increased risk of burns due to faster setting time.
Fiberglass often comes readymade with one layer of padding, however it is still essential to use extra padding prior to placement of the splint.
If possible, include joints above and below the fracture or dislocation in the splint.
In general, splint in the position of function.
Always assess and document neurovascular status before and after application of a splint.
Increased risk with increasing layers of plaster.
Less likely than with a cast.
When in doubt, take off the splint if there is ANY concern for ischemia.
Make sure there is plenty of padding, especially over bony prominences.
Ensure there is no open fracture prior to placement of any splint.
Clean and dress all wounds prior to placement of the splint.
If a high-risk wound is present, consider cutting out a window in splinting material to perform dressing changes and monitor wound.
Prophylactic antibiotics are controversial.
|Common Immobilization Techniques||Common Clinical Indications|
|Sling and Swath|
|Cuff and Collar|
|Burkhalter (Figure 14.1)|
|Radial Gutter (Figure 14.2)|
|Ulnar Gutter (Figure 14.3)|
|Volar Wrist (Figure 14.4)|
|Thumb Spica (Figure 14.5)|
|Posterior Long Arm (Figure 14.6)|
|Forearm Sugar-Tong (Figure 14.7)|
|Double Sugar-tong (Figure 14.8)|
|Posterior Long Leg (Figure 14.9)|
|Posterior Short Leg (Figures 14.10A and B)|
|Ankle Stirrup (Figure 14.11)|
|Short-Leg Walking Boot|