UE XR

Question 1

Posterior Long Arm Splint

• Indications
• Procedure
• Postioning

Answer 1

1. Olecranon, humus and radial head/neck fractures
2. Start at posterior proximal arm => down ulnar forearm => end at MCP
3. Postioning
   
   1. Flex elbow 90
   2. Position forearm neutral with thumb pointing up
   3. Extend wrist 10-20, like holding a can

Question 2

Volar Splint

1. Indications
2. Procedure
3. Positioning

Answer 2

• • Soft tissue injuries of the hand and wrist
• • Fracture to carpal bone
• Frature to 2^nd - 5^th metacarpal head fractures
• Procedure:*
• Start at metacarpal heads and end at distal forearm
• Positioning:*
• Forearm in neutral position with thumb pointing up
• Wrist extended 10-20° (as if holding a can)

Question 3

Sugar tong splint:

1. Indications
2. Procedure
3. Positioning

Answer 3

• Indications:*
• Ffracture to distal radius and/or ulna fracture
• Procedure:*
• Start at dorsal metacarpal heads => end at volar MCP joints
• Positioning:*
• Elbow flex to 90°
• Forearm in neutral position with thumb up
• Wrist extended 10-20° (as if holding a can)

Question 4

Double Sugar tong splint:

1. Indications
2. Procedure
3. Positioning

Answer 4

Indications:

Complex and unstable forearm fractures

Elbow fractures

Procedure:

Forearm sugar tong splint (place first): start at dorsal metacarpal heads and end at volar MCP Joints

Arm sugar tong splint: start at medial proximal humerus, wrap around elbow, end at lateral proximal humerus

Positioning:

• Elbow flex 90°
• Forearm in neutral position with thumb up
• Wrist extended 10-20° (as if holding a can)

Question 5

Radial Gutter Splint

1. Indication
2. Procedure
3. Positioning

Answer 5

• Indications:
• Fracture/ST injury to 2^nd and 3^rd fingers
• Fracture to neck/shaft/base of 2^nd and 3^rd metacarpal

Procedure:

• Start at radial side of mid-forearm, end at mid distal phalanx of 2^nd and 3^rd digits

Positioning:

• Forearm in neutral position
• Wrist extended 10-20° (as if holding a can)
• Thumb AB-ducted
• MCP flexed 50-70° (90° for metacarpal neck fractures)

Question 6

Thumb Sica Splint

1. Indication
2. Procedure
3. Positioning

Answer 6

• Indications:
• Injuries to scaphoid, lunate, thumb and 1st metacarpal
• Game keepers/skiers thumb
• de Quervain’s tenosynovitis

Procedure:

• Start at mid distal phalanx of thumb => end at mid-forearm

Positioning:

• Forearm in neutral position
• Wrist extended 10-20° (as if holding a can)
• Thumb AB-ducted (as if holding wine glas)

Question 7

Ulnar Gutter Splint

1. Indication
2. Procedure
3. Positioning

Answer 7

Indications:

• Fracture to 5th finger/ST injuries
• Fracture of neck, shaft, base of 4th/5th metacarpal

Procedure:

• Start at at ulnar side of mid-forearm => end at mid distal phalanx of 4^th and 5^th digits

Positioning:

• Forearm in neutral position
• Wrist extended 10-20° (as if holding a can)
• MCP is flexed 50-70 (90 for boxers fx)
• PIP and DIP flexed 5-10

Question 9

Mallet Splint

1. Indication
2. Procedure
3. Positioning

Answer 9

Indications:

• Injury to Mallet Finger

Procedure:

• Splint only the DIP on dorsal side

Positioning:

• Full extension (NOT hyperextension)

Question 10

Finger Splint

1. Indication
2. Procedure
3. Positioning

Answer 10

Indications:

• Fracture/dislocation to phalynx
• PIP/MCP dislocations
• Injuries to tendon

Procedure:

• Typically use prefabricated splint or cut splinting material to proper size
• Can be placed on dorsal or volar side, extending from fingertip to mid-hand or distal forearm depending on the joints requiring immobilization

Positioning:

• MCP is flexed 50
• PIP and DIP flexed 15-20
• To repair tendon: splint should be either in flexion or extension

Question 11

type of XR for elbow

Answer 11

AP and lateral with elbow flexed

Question 12

type of XR for forearm

Answer 12

AP and lateral

Question 13

Type of XR for wrist

Answer 13

AP, lateral and oblique

(the oblique view is helpful for curved or overlapping joints)