Orthopedic injuries are commonly encountered in primary care settings. Splinting is performed to manage various musculoskeletal injuries. Splinting is a non-circumferential application of immobilizers in injured extremities used to stabilize fractures, sprains and dislocations to allow for swelling and stimulate healing. Immobilization of fracture site involves splinting the joint above and below to maintain the position of the joint. Most splints should be applied on short-term basis to prevent complications such as muscle atrophy, joint stiffness and complex regional pain syndrome.
Splints are useful in stabilizing displaced or nondisplaced stable fractures, post laceration repairs, tendon lacerations, soft tissue sprains and strains. Splints allow for swelling that occur as a result of inflammation during an injury. It is fast, easy to apply and necessary for immobilizing musculoskeletal injuries awaiting orthopedic assessment. Monitoring of patients with splints is necessary to decrease associated complications.
- Splinting material (e.g., Ortho-Glass®, fiberglass)
- Cotton Padding
- Water (Optional for wet splint)
- Elastic bandage
- Position patient in an upright position.
- Identify the joints to stabilize.
- Place the extremity in its position of function
Post Procedure Steps
- Educate patient to report any numbness, tingling, excessive pain, or discoloration of digits.
- Educate patient to report fever, odor, drainage, redness, or streaking of laceration repair.
The Wet Splint Method
- Place the stockinette on the affected extremity (to protect the skin).
- Begin with overlapping cotton padding.
- Wet the splinting material (e.g., fiberglass) and apply over the cotton padding. Tip: check the manufacturer recommendations regarding how water affects the time to set the splint material
- Mold the splint to the affected extremity.
- Fold back the stockinette and padding to smoothen edges.
Post Procedure Steps
- Educate patient to report any numbness, tingling, excessive pain, discoloration of digits.
- Educate patient to report fever, odor, drainage, redness, streaking of laceration repair.
The Dry Splint Method
- Measure the stockinette to cover the area with excess to fold back over the splint material.
- Apply the stockinette as indicated.
- Begin by applying 6-10 cotton padding to upper extremities.
- Measure the splint material and add an additional 1-2cm at each end to allow for shrinkage.
- Place a dry splint on the affected extremity
- Apply elastic bandage to the padding for stability.
Follow up is required within 1-2 weeks of splint or cast application. Fractures generally heal in 4-8 weeks. Educate patients on need for compliance when splints are placed, since they could be easily removed. Recognize that splints use can lead to increased motion at the site of injury, use of slings may be helpful to decrease motion. Splints should not be used to immobilize unstable fractures.