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Hughes Spalding
Childrens Hospital
Dan Hirsh, MD
Emory PECC Orientation
June 19, 2008
A splint is a noncircumferential
immobilization device to
treat fractures, lacerations
of skin or tendon, and
sprains.
Complications
Risk of ischemia
Compartment Syndrome
Possible neurovascular compromise
Prevention
Keep splint snug
Check distal neurovascular status
after placement
Pain or Ineffective
Immobilization
Use padding
Avoid kinks
Check splint after
placement
If either of these too, replace the
splint
Stockinette
Ace wrap
Webril /
wadding
Optional: Apply
stockinet to
extremity
Extend it past the proximal and
distal ends of where the splint will
end
Cut out any areas that bunch up
that could damage the skin
Create thumb hole
Some fiberglass
material comes with a
thick padded side and a
thin side. Protect the
skin. Always place the
thick-side to the skinside.
Keep joint in a
protective position.
Keep hand slightly
extended at the wrist,
thumb-up, fingers
curved around an
object
Discharge Instructions
Make sure neurovascular intact & in not pain
from splint
Elevate, ice & rest injured extremity
Keep splint dry
Splints are non/partial weight bearing, use
crutches
If fingers become tingly or blue, re-wrap the
bandage
If splint hurts, or there is increasing pain, TAKE
THE SPLINT OFF! Seek medical attention
Posterior
Arm
Used for stable elbow
injuries
Width: arm
circumference
Length: dorsal aspect of
mid-upper arm down
ulnar side to distal
palmer flexion crease
Sugar Tong
Gutter
Metacarpal and/or proximal
phalnageal fractures
Ulnar immobilizes 5th & 4th
digits, radial 2nd & 3rd
Width: wrap to midline of
hand on dorsal and volar
surfaces
Length: nail base to proximal
forearm
Volar
Distal forearm or
wrist fractures
Dont use in small
children
Width: fully cover
volar aspect of
forearm
Length: from
proximal fingers to
proximal forearm
Thumb Spica
Non-displaced
fractures of 1st
metacarpal bone,
proximal phalanx of
thumb, scaphoid
fracture
Length: nail base to
proximal forearm
Posterior
Leg
Distal Tibia and/or
fibula injuries, ankle,
foot
Width: at least leg
circumference, but
NON-circumferential
Length: level of
fibular neck to base
of digits
Shape splint into
neutral position, 90
flexion
Buddy Tape
Padded metal
strip may go
dorsal or volar
Stirrup
Thumb
Spica
Volar