9. Splinting and Immobilizing

Question 1

29. Factors to be considered when deciding whether to splint

Answer 1

-mechanical factors; FRACTURES! any type 1-10 points
-biological factors: age, health status, poor soft tissue envelope, cortical bone, high.velocity injury, extensive approach 1-10 (1 caution, 10 little risk)
-clinical factors: poor client or patient compliance, wimp, high comfort level required

> fracture characteristics
duration until repair and possible surgical option
patient’s overall condition
availability of aftercare

Question 2

31. Commonly used splints and potential complications

Answer 2

-RJB= Robert-Jones bandage: most usd, pre-and postoperative:
>pros: minimal risk of vascular damage, minimal swell, prevent add.soft tissue damage by sharp bone fragments, elimination of dead space after surgery, easy use
>cons : minimal stability of bone fragments
>material: tape, cotton gauze, cotton padding, elastic tape

-spoon splint: sam splint, plastic; used to immobilize fracture-distal radius and/or ulna, carpus or tarsus, metacarpus or metatarsus
>materials: spoon splint, tape, cotton padding, cotton gauze, elastic tape

-Spica splint: immobilize fractured humerus or femur, torso is enveloped
>materials: tape, cotton pad, cast material, cotton gauze, elastic tape
-Fiberglass cast

COMPLICATIONS:
-distal oedema
-splint slippage
-skin damage-maceration
-delayed surgical site healing
-nonunion
-ischemic necrosis

Question 3

31. Commonly used slings and indications

Answer 3

-Velpeau sling:
>prevent weight bear on forelimb
>paw pad injuries: carpal sling can be more comfortable
>shoulder luxations
>muscle/ligament tears
>scapular fractures

-Ehmer sling:
>prevents weight-bearing on hind limb: paw pad injuries, hip luxation, muscle/ligament tear

-vet patients sedated during application
-cast/splints checked/changed every 2 weeks
-padding!! to prevent major skin irritation/wounds
-skin must be dry
-cast/splint must stay dry and clean
-any visible changes to cast/splint warrant re-application