Splinting 101: Basic Principles, Materials, and Types of Splints

Learn the fundamental principles of splinting from Assistant Professor Dr. Carl Kaplan, covering indications, materials needed, and various types of splints such as short arm, volar, radial gutter, ulnar gutter, and thumb spica. Discover when to use each type for different orthopedic injuries and fractures, ensuring proper immobilization and aftercare to promote healing.

• Splinting
• Orthopedic
• Injuries
• Fractures
• Materials

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1. Splinting 101 Carl Kaplan, MD Assistant Professor of Clinical Pediatrics and Emergency Medicine Renaissance School of Medicine at Stony Brook University

2. Overview Basic principles Materials Types of splints Aftercare

3. Basic Principles Indications Immobilization of acute orthopedic fractures or dislocations Immobilization of ligamentous or tendinous injuries Immobilization of wounds near mobile joints

4. Basic Principles Joint proximal/Joint distal immobilization Avoid compartment syndrome Avoid pressure necrosis Properly address underlying wounds

5. Materials Shears Cast padding (Webril) Cloth tape Splinting material Water (as needed for activation of certain materials) Fiberglass, Plaster, Aluminum/Foam, etc... Elastic wrap (ACE, Coban) Assistance

6. Short Arm Splints Hand - Position of function (neutral position) 25-30 degrees wrist extension 60-90 degrees MCP flexion 10-30 degrees PIP flexion 5-15 degrees DIP flexion

7. Volar Splint Indications Single forearm bone buckle (torus) fracture Multiple Metacarpal fractures Wrist Sprain

8. Radial Gutter Splint Indications 2nd or 3rd Metacarparpal fractures or dislocations Significant 2nd or 3rd Proximal phalanx fractures Known or suspected tendon injuries of 2nd or 3rd digits

9. Ulnar gutter splint Indications 4th or 5th Metacarparpal fractures or dislocations Significant 4th or 5th Proximal phalanx fractures Known or suspected tendon injuries of 4th or 5th digits

10. Gutter splints

11. Thumb Spica splint Indications Thumb fractures or dislocations Thumb sprains or tendon injuries Suspected scaphoid (navicular) fractures

12. Finger splints Buddy Taping or Aluminum/Foam Indications Phalangeal fractures PIP or DIP dislocations Sprains Tendon injuries (Aluminum/Foam only)

13. Long Arm splints Sugar Tong (ST) or Posterior (P) Indications Radius or Ulna fractures of forearm (ST) Dislocations at wrist (ST) or elbow (P) Distal humerus fractures (P)

14. Sugar tong splint

15. Posterior long arm splint

16. Short leg splints Indications Select distal Tibia and Fibula fractures High grade ankle sprains Achilles tendon injuries Mid-foot or metatarsal fractures

17. Posterior Short Leg splint

18. Stirrup or U splint

19. Combination short leg splint

20. Posterior Long Leg splint Indications Tibia or Fibula fractures or dislocations Patella fracture, dislocation, or tendon injuries Distal Femur fractures

21. Aftercare Rest, Ice, Elevation (2-3 days) Loosen splint if paresthesias or digital color changes develop Analgesia Crutches or Slings as indicated Do not get wet Arrange follow up

22. Documentation (Fracture/ Dislocation Procedure *ED)

23. Questions???