Clin Skills 4 Splinting Flashcards
Immediately upon presentation with a dislocation or fracture, what must be checked? (2)
neurovascular and circulatory status
Radiographs should be obtained __ reduction and IMMOBILIZATION of a fracture or dislocation.
after
Used to temporarily immobilize fractures, dislocations, and soft tissue injuries.
ideal for the ED – allow swelling and are easier to apply
Splinting
Plaster of Paris
fast drying: __minutes
extra-fast drying: __ minutes, but less time to mold
Fast drying - 5 - 8 minutes to set
Extra fast-drying - 2 - 4 minutes to set
of layers of plaster of paris:
upper extremities
lower
Upper extremities - use 8-10 layers
Lower extremities - 12-15 layers, up to 20 if big person
Elbow and forearm fx - prox/mid/distal radius and ulnar fx.
Better for most distal forearm and elbow fx because limits flex/extension and pronation / supination.
Double sugar tong
Soft tissue hand / wrist injuries - sprain, carpal tunnel night splints, etc
Most wrist fx, 2nd -5th metacarpal fx.
Most add a dorsal splint for increased stability - ‘sandwich splint’ (B).
Not used for distal radius or ulnar fx - can still supinate and pronate.
Forearm Volar Splint aka ‘Cockup’ Splint
Minimally displaced mid and distal radius and ulnar fx .
Immobilizes elbow and wrist joints to prevent pronation / supination
Forearm Sugar Tong
The correct position for most hand splints is the position of function, a.k.a. the neutral position:
beer can position.
wrist slightly extended w/ fingers flexed.
When immobilizing metacarpal neck fractures, the MCP joint should be positioned how?
flexed to 60-90º
For thumb fx, immobilize the thumb how?
as if holding wine glass
Phalangeal and metacarpal fractures, and soft tissue injuries of the little and ring fingers
Ulnar Gutter splint
Phalangeal and metacarpal fractures, and soft tissue injuries of index and middle fingers.
Radial Gutter splint
Scaphoid injuries - seen or suspected (check snuffbox tenderness)
thumb spica
Carpometocarpal subluxations of thumb
Thumb Spica
De Quervain tenosynovitis
Thumb Spica
Thumb spica positioning
Positioned like radial gutter but only thumb immobilized
Notching the plaster (shown) prevents buckling when wrapping around thumb.
Wine glass position.
finger sprain:
finger splint (buddy taping)
__ splints for phalangeal fx,
though __ splints probably better for proximal fxs.
dorsal/volar finger splints
gutter
Short term immobilization of soft tissue and ligamentous injuries to the knee or calf.
Jones Compression Dressing - aka Bulky Jones
Allows slight flexion and extension - may add posterior knee splint to further immobilize the knee.
Distal tibia/fibula fx.
Posterior Ankle Splint
Reduced dislocations
Posterior Ankle Splint
Tarsal / metatarsal fx
Posterior Ankle Splint
Similiar to posterior splint.
Less inversion /eversion and actually less plantar flexion compared to posterior splint.
Great for ankle sprains.
Stirrup splint
