1. Splinting 101 Carl Kaplan, MD
Assistant Professor of Clinical Pediatrics and Emergency Medicine
Stony Brook University School of Medicine

2. Overview
Basic principles
Materials
Types of splints
Aftercare

3. Basic Principles Indications
Immobilization of acute orthopedic fractures or dislocations
Immobilization of ligamentous or tendinous injuries
Immobilization of wounds near mobile joints

4. Basic Principles Joint proximal/Joint distal immobilization
Avoid compartment syndrome
Avoid pressure necrosis
Properly address underlying wounds

5. Materials Cast padding (Webril) Shears Splinting material Cloth tape
Fiberglass, Plaster, Aluminum/Foam, etc...
Elastic wrap (ACE, Coban)
Shears
Cloth tape
Water (as needed for activation of certain materials)
Assistance

6. Short Arm Splints Hand - Position of function (neutral position)
25-30 degrees wrist extension
60-90 degrees MCP flexion
10-30 degrees PIP flexion
5-15 degrees DIP flexion

7. Volar Splint Indications Single forearm bone buckle (torus) fracture
Multiple Metacarpal fractures
Wrist Sprain

8. Radial Gutter Splint Indications
2nd or 3rd Metacarparpal fractures or dislocations
Significant 2nd or 3rd Proximal phalanx fractures
Known or suspected tendon injuries of 2nd or 3rd digits

9. Ulnar gutter splint Indications
4th or 5th Metacarparpal fractures or dislocations
Significant 4th or 5th Proximal phalanx fractures
Known or suspected tendon injuries of 4th or 5th digits

10. Gutter splints

11. Thumb Spica splint Indications Thumb fractures or dislocations
Thumb sprains or tendon injuries
Suspected scaphoid (navicular) fractures

12. Finger splints Buddy Taping or Aluminum/Foam Indications
Phalangeal fractures
PIP or DIP dislocations
Sprains
Tendon injuries (Aluminum/Foam only)

13. Long Arm splints Sugar Tong (ST) or Posterior (P) Indications
Radius or Ulna fractures of forearm (ST)
Dislocations at wrist (ST) or elbow (P)
Distal humerus fractures (P)

14. Sugar tong splint

15. Posterior long arm splint

16. Short leg splints Indications Select distal Tibia and Fibula fractures
High grade ankle sprains
Achilles tendon injuries
Mid-foot or metatarsal fractures

17. Posterior Short Leg splint

18. Stirrup or ‘U’ splint

19. Combination short leg splint

20. Posterior Long Leg splint
Indications
Tibia or Fibula fractures or dislocations
Patella fracture, dislocation, or tendon injuries
Distal Femur fractures

21. Aftercare Rest, Ice, Elevation (2-3 days)
Loosen splint if paresthesias or digital color changes develop
Analgesia
Crutches or Slings as indicated
Do not get wet
Arrange follow up

22. Documentation (Fracture/ Dislocation Procedure *ED)

23. Questions???