Splinting Pocket Guide

Transcription

1 Performance Splinting TM Splinting Pocket Guide Tel: Fax www.

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3 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 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 degrees flexion, 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.

4 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 minimal 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.

5 Volar Splint Use 3 or 4 Measure from the base of fingers to 2 from the antecubital. Cut and prepare splint. Fold edge 1 to form pad and position splint at angle of palmer crease. Apply splint with elastic wrap. Mold with palm and position as prescribed. Indications: Wrist Sprains, Soft Tissue Injuries, Lacerations, Night Splints Volar Splint

6 Volar Dorsal Use 3 or 4 Measure starting 1 above the palmer crease to 2 from the antecubital. Double measurement. Cut and prepare splint. Cut splint at middle from closed edge to taped edge leaving 1/2 hinge on taped edge. Stretch padding over 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

7 Thumb Spica Use 3 or 4 Measure starting at tip of thumb to 2 from the antecubital. Cut and prepare splint. Apply splint starting at thumb, smoothing over the 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

8 Open Thumb Use 4 or 5 Use 6 for the entire hand Measure from the tip of 3rd finger to 2 from the antecubital. Open padding at taped edge. Fold fiberglass in 1/2, cut half moon for thumb hole. Replace padding, cut slit in padding aligning with hole in fiberglass. Place thumb through hole. Fold splint over 2nd & 3rd metacarpals. Secure splint with elastic wrap. Mold with palm and position as prescribed. Indications: 2nd & 3rd Metacarpal Fractures, Tendon Repairs, Crushing Injuries Open Thumb

9 Boxer/Ulnar Gutter Use 4 or 5 Measure from the tip of the 5th finger to 2 from the antecubital. Cut and prepare splint. Place padding between 4th and 5th fingers. Apply splint as a gutter to the ulnar side of the hand. Secure with elastic wrap. Mold with palm and position as prescribed. Indications: 4th & 5th Metacarpal Fractures Boxer/Ulner Gutter

10 Reverse Sugar Tong Use 3 or 4 Measure starting from the fingertips, down under the elbow, up to fingertips. Cut splint at middle from closed edge to taped edge, leaving 1/2 hinge on taped side. Stretch padding over edges. Place hinge at webspace, draping splint over volar and dorsal sides. Secure splint with elastic wrap. Tuck one side of splint under elbow, overlapping other side. Finish wrapping in figure-8 pattern to lock in position Indications: Colles Fracture, Forearm Fracture Reverse Sugar Tong

11 Elbow Splint Use 4 or 5 Measure from the base of the 5th metacarpal and 3 away from the axilla. Apply splint, overlapping corners of splint at the elbow. Apply splint with elastic wrap. Mold with palm and position as prescribed. Indications: Elbow Sprains, Supracondylar Fractures Elbow Splint

12 Knee Immobilizer Use 4 or 5 Use 6 for large adult Measure 8-10 inches above and below patella. Double measurement. Cut splint at middle from closed edge to taped edge, leaving 1/2 hinge on taped side. Stretch padding over edges. Apply splint sections on either side of patella with hinge located as shown. Secure splint with elastic wrap, working distal to proximal. Mold with palm and position as prescribed. Indications: Knee injuries, Post-op Knee Surgery Knee Immobilizer

13 Posterior Ankle Use 4 or 5 Measure starting 2 beyond the toes to 2 below the popliteal. Fold splint under at toes for comfort, place splint beyond and begin wrapping at toes and up foot, excluding ankle, wrap once at achilles. Fold corners of splint below ankle. Continue wrapping elastic 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

14 Ankle Stirrup Use 3 Measure starting approximately 2 below the patella from lateral side, under heel, up to medial side of patella. Open padding at taped edge in heel area of splint, cut out 3 of fiberglass for heel 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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16 Splinting Pocket Guide Tel: Fax www.