Coaptation Slab

Definition:
• Non operative method for acute management of humeral shaft
fractures. Following the application of padding to protect the skin, the
splint is applied to extend from the axilla, around the elbow, to above
the shoulder. These method provide dependency traction as well as
stabilization of the fracture through the compressive force of the
surrounding soft tissue.

Sherman, Scott. 2015. Simon’s Emergency Orthopaedics. Ed. VII. Chicago. MC Graw Hill.
Indication :
• Temporary Immobilization for :
• Acute fractures of the humeral diaphysis, proximal or midshaft with
minimal shortening and for short oblique or transverse fracture
patterns that may displace with a hanging arm cast
• Postoperative splinting following operative reduction and internal
fixation.

Thomsen TW, Setnik GS. Consult, P., n.d. Coaptation Splint.

[Online] Available at: http://www.procedureconsult.com
[Accessed 18 April 2018]
Equipment

• Slightly warm water and bucket

• Stockinette ( Optional )
• Soft Cotton Bandage/ Underspline material ( e.g. Webril padding ), 4- to 6-
inch
• Plester Bandages
• Elastic Bandages
• Adhesive Tape

Thomsen TW, Setnik GS. Consult, P., n.d. Coaptation Splint.

[Online] Available at: http://www.procedureconsult.com
[Accessed 18 April 2018]
Procedure
1. Prepare cast padding
- Position the patient’s uninjured elbow at 90 degree angle to the upper extremity
- Locate the AC joint and 2 inches distal to the axilla region
- Measure from the 1 inch proximal to the AC joint to 2 inches posterior around the elbow, to 2 inches distal to the axillar region
2. Prepare plaster splint for the anterior and posterior aspect of the upper arm
- Place sheet from the base of the deltoid muscle around elbow to 2 inches from the axillar region.
3. Applied splint to injured upper arm
4. Secured coaptation splint to injured arm
5. Check ROM of phalanges and thumb
- Have patient extend. Flex fingers and touch thumb to all fingers
- Have patient extend and flex wrist
6. Check splint dimension
- The proximal edge of the splint is superior to the AC joint
- The proximal edge of the splint rest 2 inches to the axillary region
7. Check patient CRT

Thomsen TW, Setnik GS. Consult, P., n.d. Coaptation Splint.

[Online] Available at: http://www.procedureconsult.com
[Accessed 18 April 2018]
Complication
• Nerve Palsy
• Pressure Sore
• Vascular compression
• Joint Stifness

Thomsen TW, Setnik GS. Consult, P., n.d. Coaptation Splint.

[Online] Available at: http://www.procedureconsult.com
[Accessed 18 April 2018]
U-Slab
 Definition:
• A plaster slab extending from the base of the neck, over the shoulder
into the lateral aspect of the arm, under the elbow to medial side of
the arm.

Munir A, Shah JZ. Functional Humerus Brase vs U-Slab inhumeral shaft fractures: a randomized control trial. Isra Medical Journal. 2015,7(4):200-3.
 Indication :
• Temporary Immobilization for acute fractures of the humeral midshaft

Munir A, Shah JZ. Functional Humerus Brase vs U-Slab inhumeral shaft fractures: a randomized control trial. Isra Medical Journal. 2015,7(4):200-3.
 Procedure
• Thermoplastic polyethylene brace extending in the medial aspect of
2,5 cm below the axillar region to a level of 1,3 cm over the medial
epicondyle
• Extending in the lateral aspect from immediately over the acromion
to the lateral epicondyle of the humerus was applied to all the patient
with the help of the measure taken from the intact arm, so as to leave
the antecubital region open, and to allow flexion of the elbow up to
120 degree.
• Addesive bends were arranged according to the scaring in the soft
tissues and brace was used continuously
Munir A, Shah JZ. Functional Humerus Brase vs U-Slab inhumeral shaft fractures: a randomized control trial. Isra Medical Journal. 2015,7(4):200-3.