Splinting & Casting Flashcards
General Fracture Management
– Maintain anatomic fracture alignment throughout treatment.
– Stable fractures are generally re-evaluated within one to two weeks following cast application to
assess cast fit & condition, & to perform radiography to monitor healing & fracture alignment.
* Hand & forearm fractures are often re-evaluated within the first week
– Displaced fractures require closed reduction, followed by post-reduction radiography to confirm bone
alignment.
– Both displaced & unstable fractures should be monitored vigilantly to ensure maintained
positioning.
If an open wound is present, what should you do?
apply a sterile dressing, and check
with orthopedist for all open wounds
Immobilize the joints _____ the suspected fracture site
above & below
Typically position the joint to a _____ position when splinting or casting
neutral
As a general rule, casts are rarely used for the initial treatment. In an
acute setting, like an ER/Urgent Care, always use _____
a splint
Prefabricated splints pros and cons
– Benefits: quick, easy, works in some
situations, easily removable
– Cons: One size fits most, lack the ability to
customize to the patients needs
– Typically used emergently &/or when needed
only for a short period of time
Custom Splints pros and cons
– Plaster splints are seldom used anymore
– Fiberglass splints have the advantage of
being lighter, more sanitary, & are typically
more durable than plaster casting
Ulnar Gutter Splint indications and positioning
– Indications
* 4th metacarpal fracture
* 5th metacarpal fracture
– Positioning
* MCP joints at 70 to 90 degrees of flexion
* PIP & DIP joints at 5 to 10 degrees of flexion
Ulnar Gutter Splint – Follow-Up
- One to two weeks
- Refer for angulated, displaced, rotated, oblique, or
intra-articular fracture or failed closed reduction
Ulnar Gutter Cast indications and positioning
– Indications
* 4th metacarpal fracture
* 5th metacarpal fracture
– Positioning
* MCP joints at 70 to 90 degrees of flexion
* PIP & DIP joints at 5 to 10 degrees of flexion
Ulnar Gutter Cast follow up
One to two weeks
Volar Splint indications and positioning
– Indications
* Wrist sprain/strain
* Carpal Tunnel
* Lacerations
* Night Splint
– Positioning
* Wrist is neutral or slightly extended
* MCP joints are free
Volar Splint follow up
- 1-2 weeks
- Refer for angulated, displaced, rotated, oblique, or
intra-articular fracture or failed closed reduction
Thumb Spica Splint indications and positioning
– Indications
* Scaphoid fracture maybe?
* Thumb dislocation
* Thumb fracture
– Positioning
* “Hold a soda can”
Thumb Spica Splint follow up
- One to two weeks
- Refer for angulated, displaced, intra-articular,
incompletely reduced, or unstable fracture - Refer displaced fracture of the scaphoid
