Lecture 9, splinting and immobilizing

Question 1

Purpose of a splint

Answer 1

• Temporary immobilization
• Treatment of fractures
  +/- surgery
• Prevention of self-mutilation
• Reduction of oedema

Question 2

Splint or not splint, factors that must be taken into account

Answer 2

• Fracture characteristics
• Duration until repair and possible surgical options
• Patient’s overall condition
• Availability of aftercare

Splint only in case of favourable conditions

Question 3

Complications of splint

Answer 3

• Distal oedema
• Splint slippage
• Skin damage – maceration
• Delayed surgical site healing
• Nonunion
• Ischemic necrosis

Question 4

Different splints and casts

Answer 4

• Robert-Jones bandage
• Spoon splint
  
  • Sam splint
  • Plastic
• Spica splint
• Fiberglass cast

Question 5

Robert-Jones bandage

Answer 5

• Most commonly used
• Pre- and/or postoperative use

Pros:
* Minimal risk of vascular damage
* Minimization of swelling
- Enhanced visualization and
palpation of anatomic landmarks
during surgery
* Prevention of additional soft tissue damage by sharp bone fragments
* Elimination of dead space after surgery
* Easy to use

Cons:
* Only minimal stability of bone fragments

• Tape
• Cotton gauze
• Cotton padding
• Elastic tape

Question 6

Spoon splint

Answer 6

• Used to immobilize fractured:
  
  • Distal radius and/or ulna
  • Carpus or tarsus
  • Metacarpus or metatarsus
• Usually made of aluminium or plastic
• Spoon splint
• Tape
• Cotton padding
• Cotton gauze
• Elastic tape

Question 7

Spica splint

Answer 7

• Used to immobilize fractured humerus or femur
• Torso is enveloped
• Tape
• Cotton padding
• Cast material
• Cotton gauze
• Elastic tape

Question 8

Slings used for immobilizing

Answer 8

Velpeau
Ehmer

Question 9

Velpeau sling

Answer 9

• Prevents weight-bearing on the forelimb
• Paw pad injuries
• Carpal sling may be more comfortable
• Shoulder luxations
• Muscle/ligament tears
• Scapular fracures

Question 10

Ehmer sling

Answer 10

• Prevents weight-bearing on the hind limb
  
  • Paw pad injuries
  • Hip luxation
  • Muscle/ligament tear

Question 11

Splinting & immobilization

Answer 11

• Patients often have to be sedated during application
• Cast/splints should be checked/changed at least every 2 weeks!
• Recommended first recheck after 1 week
• Padding extremely important to prevent major skin irritation/wounds
  
  • Also the edges of the cast
• The skin must be dry
• The cast/splint must stay dry and clean
• Any visible changes to the cast/splint warrant re-application