Performance SplintingTM

Splinting
Pocket
Guide

Tel: 877.631.3077 • Fax 336.631.3060

www.CNFMedical.com
 Positions of Function

These functional positions are indicated for many injuries and are
a general guideline only. It is important to position appropriate to
the injury, individual patient needs, and physician preference.
1. VOLAR SPLINT – Position the wrist at neutral to 20 degrees
extension and allow free motion of all fingers and thumb.
2. VOLAR DORSAL – Position the wrist at 20 degrees extension,
allowing free motion of all fingers and thumb.
3. THUMB SPICA – Place thumb in a functional position with the
wrist in approximately 30 degrees extension and thumb and index
finger in opposition.
4. OPEN THUMB – Flex Metacarpals in 45 - 70 degree angle and
wrist in 20 degrees extention.
5. BOXER/ULNAR GUTTER (4th-5th Metacarpal) – Position the
wrist at 20 degrees extension, the MCP joint at 45-70 degrees flex-
ion, depending on the injury.
6. REVERSE SUGAR TONG – Position the wrist at neutral and
the elbow flexed at 90 degrees.
7. ELBOW SPLINT – Position the wrist at neutral and the elbow at
90 degrees.
8. KNEE IMMOBILIZER – The physician will want to splint
the knee fully extended if possible, but for proper gait and crutch
walking a 15 degree flexion at the knee may be necessary.
9. POSTERIOR ANKLE – Position with the ankle at 90 degrees
(neutral), unless otherwise instructed.
10. ANKLE STIRRUP – The foot should be flexed at a 90 degree
angle, unless otherwise directed.

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Preparation Guidelines
1. Choose splint material width (2” to 6”).
2. Cut length as measured.
3. Push splint roll back inside foil, then reseal foil end with clip.
4. Stretch padding over both ends to cover exposed fiberglass edges.
5. Use minimal amount of cool water to activate.
6. Roll in towel twice to remove excess water.
7. Apply padding to patient, then secure splint with elastic bandage.
8. Mold splint to extremity with palm.
9. Monitor patient according to standard procedures.

Tips for Better Splinting

1. Pre and post splint checks are imperative.
Use this formula: F - A - C - T - S to check for
Function
Arterial Pulse
Capillary Refill
Temperature - skin
Sensation
2. Always use cool, clean water. Do not over-saturate splint. A mini-
mal amount of water is required to start the setup process.
3. Protect or pad edges of splint.
4. Smooth splint with palm after placing on patient.
5. Roll elastic bandage on the extremity without
tension. Too much tension could lead to
circulation issues and other complications.
6. Leave fingertips exposed to check for circulation.
7. Patient should remain still until heat subsides from the splint to
allow for proper setup.
8. Patient discharge instructions should include:
- Review F-A-C-T-S with patient.
- Review R-I-C-E Instructions:
Rest / Ice /Compression / Elevation
- Patient should not remove splint unless approved by physician.
- Patient should keep splint dry.
 Volar Splint
Use 3” or 4”

Measure from the base of Fold edge 1” to form pad and

fingers to 2” from the position splint at angle of
antecubital. Cut and palmer crease.
prepare splint.

Apply splint with elastic wrap. Mold

with palm and position as prescribed.

Indications: Wrist Sprains, Soft Tissue Injuries,

Lacerations, Night Splints

Volar Splint
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 Volar Dorsal
Use 3” or 4”

Measure starting 1” above Cut splint at middle from

the palmer crease to 2” from closed edge to taped edge
the antecubital. Double mea- leaving 1/2” hinge on taped
surement. Cut and prepare edge. Stretch padding over
splint. edges.

Place hinge on webspace Secure with elastic wrap starting at

allowing splint to cover volar
the wrist, then through web space
and dorsal sides. and around back of the hand,
working distal to proximal to
finish. Mold with palm and
position as prescribed.
Indications: Forearm fracture, severe sprains
Volar Dorsal
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 Thumb Spica
Use 3” or 4”

Measure starting at tip of Apply splint starting at

thumb to 2” from the antecu- thumb, smoothing over the
bital. Cut and prepare splint. dorsal aspect of the hand and
forearm.

Secure splint with elastic wrap at wrist, wrap around

thumb and then wrist twice in a figure-8. Finish
wrapping, working distal to proximal. Mold with palm
and position as prescribed.
Indications: Navicular Injuries, Scaphoid Fractures,
Dislocations, UCL Sprains

Thumb Spica
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 Open Thumb
Use 4” or 5”
Use 6” for the entire hand

Measure from the tip of Open padding at taped edge.

3rd finger to 2” from the Fold fiberglass in 1/2, cut half
antecubital. moon for thumb hole. Replace
padding, cut slit in padding
aligning with hole in fiberglass.

Place thumb through hole. Secure splint with elastic

Fold splint over 2nd & 3rd wrap. Mold with palm and
metacarpals. position as prescribed.

Indications: 2nd & 3rd Metacarpal Fractures,

Tendon Repairs, Crushing Injuries

Open Thumb
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 Boxer/Ulnar Gutter
Use 4” or 5”

Measure from the tip of the Place padding between 4th

5th finger to 2” from the and 5th fingers.
antecubital. Cut and prepare
splint.

Apply splint as a gutter to the Secure with elastic wrap.

ulnar side of the hand. Mold with palm and position
as prescribed.

Indications: 4th & 5th Metacarpal Fractures

Boxer/Ulner Gutter
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 Reverse Sugar Tong
Use 3” or 4”

Measure starting from the Cut splint at middle from

fingertips, down under the closed edge to taped edge,
elbow, up to fingertips. leaving 1/2” hinge on taped
side. Stretch padding over
edges.

Place hinge at webspace, Secure splint with elastic wrap.

draping splint over volar Tuck one side of splint under
and dorsal sides. elbow, overlapping other side.
Finish wrapping in figure-8
pattern to lock in position

Indications: Colles’ Fracture, Forearm Fracture

Reverse Sugar Tong

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 Elbow Splint
Use 4” or 5”

Measure from the base of the Apply splint, overlapping

5th metacarpal and 3” away corners of splint at the elbow.
from the axilla.

Apply splint with elastic wrap.

Mold with palm and position as prescribed.

Indications: Elbow Sprains, Supracondylar Fractures

Elbow Splint
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 Knee Immobilizer
Use 4” or 5”
Use 6” for large adult

Measure 8-10 inches above Cut splint at middle from

and below patella. closed edge to taped edge,
Double measurement. leaving 1/2” hinge on taped
side. Stretch padding over
edges.

Apply splint sections on Secure splint with elastic

either side of patella with wrap, working distal to
hinge located as shown. proximal. Mold with palm
and position as prescribed.
Indications: Knee injuries, Post-op Knee Surgery

Knee Immobilizer
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 Posterior Ankle
Use 4” or 5”

Measure starting 2” beyond Fold splint under at toes for

the toes to 2” below the comfort, place splint beyond
popliteal. and begin wrapping at toes
and up foot, excluding ankle,
wrap once at achilles.

Fold corners of splint Continue wrapping elastic

below ankle. bandage around heel and up
leg to 2” below the popliteal.
Mold with palm and position
as prescribed.
Indications: Ankle Sprains, Achilles Tendon Tears,
Metatarsal/Tib/Fib Fractures

Posterior Ankle
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 Ankle Stirrup
Use 3”

Measure starting approxi- Open padding at taped edge

mately 2” below the patella in heel area of splint, cut
from lateral side, under heel, out 3” of fiberglass for heel
up to medial side of patella. comfort, close padding at
taped edge.

Apply splint in stirrup style, centering heel on

“padding-only” area. Secure at ankle with elastic
wrap using several figure-8’s around plantar aspect
and ankle, working distal to proximal. Mold with
palm and position as prescribed.
Indications: Ankle Sprain, Hairline Fracture

Ankle Stirrup
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 Splinting
Pocket
Guide

Tel: 877.631.3077 • Fax 336.631.3060

www.CNFMedical.com