Clin Skills 4 Splinting

Question 1

Immediately upon presentation with a dislocation or fracture, what must be checked? (2)

Answer 1

neurovascular and circulatory status

Question 2

Radiographs should be obtained __ reduction and IMMOBILIZATION of a fracture or dislocation.

Answer 2

after

Question 3

Used to temporarily immobilize fractures, dislocations, and soft tissue injuries.
ideal for the ED – allow swelling and are easier to apply

Answer 3

Splinting

Question 4

Plaster of Paris
fast drying: __minutes
extra-fast drying: __ minutes, but less time to mold

Answer 4

Fast drying - 5 - 8 minutes to set

Extra fast-drying - 2 - 4 minutes to set

Question 5

of layers of plaster of paris:
upper extremities
lower

Answer 5

Upper extremities - use 8-10 layers

Lower extremities - 12-15 layers, up to 20 if big person

Question 6

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.

Answer 6

Double sugar tong

Question 7

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.

Answer 7

Forearm Volar Splint aka ‘Cockup’ Splint

Question 8

Minimally displaced mid and distal radius and ulnar fx .

Immobilizes elbow and wrist joints to prevent pronation / supination

Answer 8

Forearm Sugar Tong

Question 9

The correct position for most hand splints is the position of function, a.k.a. the neutral position:

Answer 9

beer can position.

wrist slightly extended w/ fingers flexed.

Question 10

When immobilizing metacarpal neck fractures, the MCP joint should be positioned how?

Answer 10

flexed to 60-90º

Question 11

For thumb fx, immobilize the thumb how?

Answer 11

as if holding wine glass

Question 12

Phalangeal and metacarpal fractures, and soft tissue injuries of the little and ring fingers

Answer 12

Ulnar Gutter splint

Question 13

Phalangeal and metacarpal fractures, and soft tissue injuries of index and middle fingers.

Answer 13

Radial Gutter splint

Question 14

Scaphoid injuries - seen or suspected (check snuffbox tenderness)

Answer 14

thumb spica

Question 15

Carpometocarpal subluxations of thumb

Answer 15

Thumb Spica

Question 16

De Quervain tenosynovitis

Answer 16

Thumb Spica

Question 17

Thumb spica positioning

Answer 17

Positioned like radial gutter but only thumb immobilized
Notching the plaster (shown) prevents buckling when wrapping around thumb.
Wine glass position.

Question 18

finger sprain:

Answer 18

finger splint (buddy taping)

Question 19

__ splints for phalangeal fx,

though __ splints probably better for proximal fxs.

Answer 19

dorsal/volar finger splints

gutter

Question 20

Short term immobilization of soft tissue and ligamentous injuries to the knee or calf.

Answer 20

Jones Compression Dressing - aka Bulky Jones

Allows slight flexion and extension - may add posterior knee splint to further immobilize the knee.

Question 21

Distal tibia/fibula fx.

Answer 21

Posterior Ankle Splint

Question 22

Reduced dislocations

Answer 22

Posterior Ankle Splint

Question 23

Tarsal / metatarsal fx

Answer 23

Posterior Ankle Splint

Question 24

Similiar to posterior splint.
Less inversion /eversion and actually less plantar flexion compared to posterior splint.
Great for ankle sprains.

Answer 24

Stirrup splint

Question 25

Semirigid brace, many models
Fastens with Velcro
Worn over clothing

Answer 25

Knee Immobilizer

Question 26

Articulated knee brace
Amount of allowed flexion and extension can be adjusted
Used for ligamentous knee injuries and post-op

Answer 26

Bledsoe Brace

Question 27

Resembles a stirrup splint with air bladders

Worn inside shoe

Answer 27

AirCast/ Airsplint

Question 28

Used for foot fractures or soft tissue injuries

Answer 28

Hard Shoe