Splinting basics
4/13/2015
1
Introduction


4/13/2015
Selected extremity splinting
techniques
Misty Wright, PA-C
2
Topics of Discussion



4/13/2015
Upper extremity
Lower extremity
Finger splinting
3
Upper extremity
splinting


4/13/2015
Volar splints used mostly for
sprains of the wrist, tendonitis, or
any inflammatory process at the
the wrist level.
A Volar splint is placed volarly on
the forearm from the palmar
crease to the proximal 1/3 forearm,
allowing movement of the thumb,
and the metacarpal phalangeal
joints.
4
4/13/2015
Volar splint
5
4/13/2015
Velcro splint
6
More UE Splints

4/13/2015
A thumb spica splint is a volar
splint with the thumb immobilized
in neutral, and used for thumb
injuries, and suspected scaphoid
fractures.
7
4/13/2015
Thumb Spica
8
One More UE Splint


4/13/2015
The Coaptation splint extends from
the axilla medially, and runs
laterally around the elbow to the
acromioclavicular joint. It is used to
immobilize mid to distal humerus
fractures.
Sarmiento Fracture cuff- midshaft
humerus fractures, circumferential
support
9
4/13/2015
10
4/13/2015
Coaptation splint
11
4/13/2015
Sarmiento fracture brace
12
The Best Upper
Extremity Splint

4/13/2015
The Sugar tong or stirrup splint for
the forearm and wrist goes from
the palmer crease, around elbow,
and ends at the dorsal MP joints. It
prevents pronation/supination of
the forearm, and is used for distal
radius and forearm fractures.
13
4/13/2015
14
4/13/2015
15
Another Upper Extremity
Splint

4/13/2015
The posterior splint is used for
elbow injuries and fractures, and
goes from the proximal 1/3 of the
humerus, posteriorly, and can stop
at the wrist, or extend to the MP
joints, as needed.
16
4/13/2015
17
4/13/2015
Posterior Splint
18
Lower Extremity Splints



4/13/2015
Short leg splints are used for foot
and ankle injuries.
The posterior splint is used for foot
and soft tissue injuries, or to
prevent equinous contracture.
The three way, trauma, stirrup, or
lower extremity sugar tong splint is
for ankle joint injuries.
19
4/13/2015
Air Splint
20
4/13/2015
21
4/13/2015
22
4/13/2015
Components of 3-way
23
4/13/2015
Cam Walker Boot
24
Lower Extremity Splints


4/13/2015
Any Bony injury above the ankle
level should be immobilized with a
long leg splint, or knee immobilizer.
Hip Reductions can go in knee
immobilizers, or an abduction
brace, to prevent re-dislocation.
25
4/13/2015
26
4/13/2015
27
4/13/2015
Long leg cast
28
4/13/2015
Abduction Pillow
29
4/13/2015
Knee Immobilizer
30
Finger Splints

4/13/2015
Use stack splints, or malleable
metal splints to splint digits in
position of comfort or reduction.
Splint Mallet, or avulsion fractures
in extension, and do not allow the
patient to remove.
31
4/13/2015
Mallet finger
32
4/13/2015
Mallet splint
33
4/13/2015
34
Splinting pitfalls

4/13/2015
Do not apply splints too tight. Use
Bias wrap for upper extremity
splints, and do not stretch elastic
when applying ace wrap.
35
Too Much splinting Is
not good



4/13/2015
Over splinting can lead to stiff
joints, and should be avoided.
Adults older than 40 at risk for
frozen shoulder/elbow syndromes.
Geriatric patients must be closely
monitored for skin breakdown.
36
Questions


Check your splints
Bill for any special applications,
molding, and splint checks.
- AHCCCS no longer pays for any
prefab splints, just FYI.
4/13/2015
37
Common fracture patterns
Is it broken or fractured?
4/13/2015
38
A word about peds fracture patterns
4/13/2015
39
Thurston Holland
fragment
Salter harris fracture- Type 2
4/13/2015
40
4/13/2015
Supracondylar fracture- Type 1
41
Supracondylar fracture- Type 2
4/13/2015
42
4/13/2015
Supracondylar fracture- Type 3
43
Common Upper
Extremity Fractures
4/13/2015
44
4/13/2015
Monteggia fracture
45
Galeazzi fracture
4/13/2015
46
4/13/2015
Scaphoid fracture
47
Terry thomas sign
4/13/2015
Scapholunate widening
48
4/13/2015
Perlinuate dislocation
49
4/13/2015
Perilunate dislocation
50
4/13/2015
Flexor Tenosynovitis
51
Kanavel Signs of Flexor
Tenosynovitis




4/13/2015
- Pain passive extension
- fusiform swelling (sausage like)
- flexed posture
- flexor sheath tenderness
52
Lower Extremity Fracture
Patterns
4/13/2015
53
Lizfranc Fracture
4/13/2015
54
4/13/2015

“just” an ankle sprain?
55
Maisonneuve Fracture
4/13/2015
56
Pilon Fracture
4/13/2015
57
Tibial Plateau Fracture

4/13/2015
Very commonly causes lateral
lower extremity Compartment
Syndrome
58
Commonly present with
Tibia Plateau Fractures
4/13/2015
59
Proximal Femur Fractures
4/13/2015
60
The End
4/13/2015
61