SPLINT

DEFINITION
 Splint:
 A device used for support or immobilization of limbs
or of the spine*
 A rigid or flexible appliance for fixation of displaced
or movable parts**
 A device used for immobilize and position one or
several joint***
 Temporary Immobilization the injured part of the
body during transportation ( fracture, dislocations
and soft tissue injury)****

*Canadian Association for Prosthetics and Orthotics website

**www.freemedicaldictionary.com
***Hoppenfeld S, Murthy VL. Treatment & Rehabilitation of Fracture
****Basic Orthopaedic Skill Course
INTRODUCTION
 After fracture, splints and braces are precribed to
protect a partially healed fracture once
weightbearing or movement is allowed
 May also used to immobilize the fracture and to
prevent pain that occur with motion

Hinged Brace Long leg splint

 TYPES OF SPLINT
Upper Extremity Lower Extremity
 Elbow/Arm • Thigh
 Long Arm Posterior – Thomas splint
 Double Sugar - Tong • Knee
 Forearm/Wrist – Bulky Jones
 Volar Forearm – Posterior Knee Splint
 Sugar - Tong • Ankle / Leg
 Hand/Fingers – Posterior leg splint
– Anterior leg splint
 Ulnar Gutter
– Stirrup splint
 Radial Gutter
 Thumb Spica • Foot
– Dennis Browne splint
 Finger Splints

Sumber: Basic Orthopaedic Skill Course

LONG ARM POSTERIOR SPLINT
 Indications
 Elbow, proximal & midshaft forearm injuries
 Distal humerus fx
 Ulnar fx in children
 Doesn’t completely eliminate supination /
pronation
DOUBLE SUGAR TONG SPLINT
 Indications
 Elbow and forearm fx - prox/mid/distal
radius and ulnar fx.
 Provide flex/extension and pronation /
supination control.
VOLAR FOREARM SPLINT
 Indications
 Soft tissue hand / wrist injuries – sprain
 Carpal tunnel night splints
 Not used for distal radius or ulnar fx: unstable can
still supinate and pronate.
 Repair of extensor tendon
FOREARM POSTERIOR SLAB
 For flexor tendon rupture
 8 – 12 layers 4 inches plaster

 30 degrees MCP flexion and 60 degrees wrist

dorsiflexion
 Metacarpal head to 2-3 cm below radial head
FOREARM SUGAR TONG SPLINT
 Indications

 Distal radius and ulnar fx

 Stabilize wrist, elbow
 Limit supination and pronation
ARM SUGAR TONG SPLINT (U-SLAB)
 Indication for mid shaft humeral fracture
 10 layers of 4 inches plaster

 Fixed in 90 degrees elbow flexion

 Padding  arm pit to medial part of the clavicle

 4 – 6 weeks
FINGER SPLINT
 Sprains - dynamic splinting (buddy taping).
 Dorsal/Volar finger splints - phalangeal fx

 Mallet finger splint

WRIST SPLINT
 Relieve pressure on the median nerve
 Carpal tunnel syndrome
ULNAR GUTTER SPLINT
 Soft tissue hand injuries to the fourth and fifth
fingers
 Fourth and fifth metacarpal fractures, boxer
fracture
 Fractures of the fourth and fifth phalanges

 Positioning for rheumatoid arthritis

 Wrist slight extension, MCP 70-90o flexion

THUMB SPICA SPLINT
 Scaphoid injuries
 Lunate injuries

 First metacarpal fractures

 Injury to the ulnar collateral

ligamentgamekeeper thumb
 Positioning for de Quervain tenosynovitis
RADIAL GUTTER SPLINT
 First metacarpal fractures
 Injury to the ulnar collateral
ligamentgamekeeper thumb
 Positioning for de Quervain tenosynovitis
THOMAS SPLINT
 a leg splint consisting of two rigid rods attached
to an ovoid ring that fits around the thigh
 it can be combined with other apparatus to
provide traction
 For Fracture of femur
POSTERIOR LEG SPLINT
 Indications
 Distal tibia/fibula fx.
 Reduced dislocations
 Sprains
 Tarsal / metatarsal fx
 Use at least 16-20 layers of plaster.
ANTERIOR LEG SPLINT
 Indications ( achilles tendon rupture, flexor
tendon rupture and flexor muscle belly rupture )
 20 layers 6 inches plaster

 30 – 55 degrees of foot plantar flexion

 Head of fibula to foot fingers

 4 – 6 weeks
STIRRUP SPLINT
 Indications
 Similiar to posterior splint.
 Less inversion /eversion and actually less plantar
flexion compared to posterior splint.
 Great for ankle sprains.
 12-15 layers of 4-6 inch plaster.
DENNIS BROWN SPLINT
 Denis Browne splint a splint consisting of a
pair boot splints joined by a cross bar
 Used in talipes equinovarus
COMPLICATION
 Thermal injury
 Release heat as plaster dries
 Hot water, Increased number of layers, extra fast-
drying, poor padding - all increase risk
 If significant pain - remove splint to cool
 Compartment syndrome
 Less risk compared to casting but still a possibility
 Do not apply elastic bandage tightly
 Elevate extremity
 Close follow up  when in doubt, release
 Pulses lost late
COMPLICATION
 Pressure sores
 Adequate padding

 Infection
 Clean, debride and dress all wounds before splint
application
 Recheck if significant exudation
REFERENSI
 Hoppenfeld S, Murthy VL. Treatment &
Rehabilitation of Fracture. 2000.
Philadelphia:Lippincott Williams & Wilkin
 DeLisa J, Ganz BM, et al. Physical Medicine &
Rehabilitation : Principle and Practice. 4th edition.
2005. Philadelphia: Lippincott Williams & Wilkin
 Charnley J. The Closed Treatment of Common
Fracture. 1999. NewYork: John Charnley Trust
 Oesman I. Basic Orthopaedic Skill Course. 2010.
Departemen Orthopaedi & Traumatologi
FKUI/RSCM
 Boyd AS, Benjamin HJ, Asplund C. Splint and Cast:
Indication and Methods. Diunduh dari www.aafp.org
tgl 5 okt 2011
THANK YOU