Physician Splinting Guide

Providers, we’re here for you too. Take a moment to review the quick splinting guides below to ensure your patients are properly splinted when you send them our way.

General Splinting Procedure

ULNAR GUTTER SPLINT

INDICATIONS

Fractures and soft tissue injuries of the small finger, or ring finger.

CONSTRUCTION

Starts at mid-forearm, runs along ulnar aspect of forearm to just beyond the DIP joint. Include the ring finger and small finger.

APPLICATION/POSITIONING

Slight wrist extension (10-20 degrees). PIP and DIP joints 10-15 degrees of flexion. 50 degrees of flexion of MCP joints or 90 degrees for Boxer’s fractures.

VOLAR SPLINT

INDICATIONS

Soft tissue injuries or fracture of the proximal hand and wrist, excluding the thumb and small finger.

CONSTRUCTION

Starts in the palm at the metacarpal heads, down the volar aspect of forearm to proximal forearm.

APPLICATION/POSITIONING

Cut hole in stockinette for thumb. Forearm in neutral position with thumb up. Wrist slightly extended (10-20 degrees).

THUMB SPICA SPLINT

INDICATIONS

Injuries to scaphoid, lunate, thumb and index finger.

CONSTRUCTION

From just distal to the interphalangeal joint of thumb to mid-forearm

APPLICATION/POSITIONING

Cut hole in stockinette for thumb. Forearm in neutral position with thumb in wineglass position.

SUGAR TONG SPLINT

INDICATIONS

Distal or mid-shaft radius and ulna fractures.

CONSTRUCTION

From MC heads on the dorsal hand, around elbow to volar MCP joints

APPLICATION/POSITIONING

Cut hole in stockinette for thumb. Elbow at 90 degrees. Forearm neutral with thumb up. Slightly extended wrist (10-20 degrees)

POSTERIOR LONG-ARM SPLINT

INDICATIONS

Injuries of the elbow and proximal forearm.

CONSTRUCTION

Starts on the posterior aspect of the proximal arm, down the ulnar aspect of arm and ends at the MCP joints.

APPLICATION/POSITIONING

Cut hole in stockinette for thumb. Elbow at 90 degrees. Forearm neutral position with thumb up. Neutral or slightly extended wrist (10-20 degrees).

POSTERIOR SHORT-LEG SPLINT

INDICATIONS

Fracture or soft tissue injury of the foot, ankle, or distal tibia up to mid shaft.

CONSTRUCTION

Start on the posterior aspect of the lower leg, just distal to the knee and extend down to the plantar foot to the tip of the toes. For ankle and tibial fractures add a second plaster component as a stirrup from mid lower leg medially around the malleoli and the plantar foot and up to the mid leg laterally

APPLICATION/POSITIONING

Ankle at 90 degrees.

POSTERIOR LONG-LEG SPLINT

INDICATIONS

Proximal tibia fracture, distal femoral fracture, soft tissue injuries around the knee.

CONSTRUCTION

Posterior leg from mid femur, past knee, past ankle to distal plantar aspect of toes.

APPLICATION/POSITIONING

Knee flexed to 30 degrees. Ankle flexed to 90 degrees.

COAPTATION SPLINT

INDICATIONS

Humerus shaft fractures.

CONSTRUCTION

From medial arm at axilla around elbow and up laterally over acromion.

APPLICATION/POSITIONING

Elbow at 90 degrees.

GENERAL SPLINTING PROCEDURE

  1. Measure and prepare the fiberglass or plaster
  2. Apply the stockinette so that it extends 2 or  3 inches beyond the fiberglass
  3. Apply 2 or 3 layers of Webril over the area to be splinted
    Be generous, avoid wrinkles, and place extra padding around bony prominences. Place Webril between the digits that are going to be splinted to avoid maceration.
  4. Wet the fiberglass and place it over the area  to be splinted
    Submerge the premeasured fiberglass in unused warm water. Remove the splint from the water and squeeze out the excess water and remove wrinkles.
  5. Fold the ends of stockinette over the the  fiberglass to smooth the edges of the splint
  1. Place a layer of Webril over the fiberglass
  2. Apply the ace wrap around the splint to secure it in place.
    Wrap the bandage without placing too much tension around the extremity
  3. While still wet, mold the fiberglass to conform to the shape of the extremity
    Use the palms of your hand rather than the fingers
  4. Place the patient’s extremity in the position desired
    Keep the patient still until the splint has dried and hardened (the fiberglass will become warm as it’s drying). Fast-drying: 5-8 minutes, extra-fast drying: 2-4 minutes
  5. After the splint has dried, check the splinted extremity for function, arterial pulse, capillary refill, temperature of skin, and sensation

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