Basic Splinting Techniques

Instructor: Maya Shapland

Maya has worked in the clinical, education, and management sections of healthcare for over 25 years and holds bachelor's degree in Speech and associate degree in Nursing.

Splinting treatment for fractures, sprains, and strains will be addressed in this lesson. Techniques for high-quality splinting and patient instructions for care are discussed.

Splints For Injuries

Gabriel, a hypothetical teenager into skateboarding, fell off a high curb and sustained a left ankle fracture. This type of fracture will take a few weeks to heal so in the meantime, a splint has been applied in the emergency department until a more formal cast can be applied.

Types of injuries requiring a splint

There are several types of injuries that require splints. They include:

  1. Sprains: Injuries of the ligaments causing pain, redness, swelling, bruising, on or near joints usually from a fall.
  2. Strains: Injuries to the tendon or muscles causing pain, swelling, and muscles may be weak or spasm caused by overuse.
  3. Fractures: A Broken bone which can be stable or unstable, open or closed, and be caused by trauma, diseases such as osteoporosis or overuse of the bone. Fractures cause pain, swelling, bruising, and, decreased mobility of the area. X-rays are the best way to diagnose fractures.

Splints are used to allow the area injured to rest, provide pain relief by keeping the area stabilized, and allow for swelling to increase and then decrease before a cast is applied. Splints can be made from a plaster-type material, compressed bandages such as an ace wrap, and boots or prefabricated upper extremity splints for wrist, forearms, knees, and ankles. Splints can provide protection from further injury.

Example of wrist splint~

Splint application may only take a few minutes and this allows Gabriel to learn about the healing process.

Basic Splint Application

Splints for both upper and lower extremity must fit without constricting the blood flow yet, supporting the area injured. Gather all the supplies you need before you begin. Once the plaster-type splinting material is wet, it will soft set rapidly. The first order in applying splints is to place the limb to be splinted in the most natural position of function. Natural position of function means the natural curve to fingers, wrists, and feet, ankles, and knees. Applying splint will help prevent muscle shortening and deformity. Wrapping with cotton padding prior to splint application prevents burning of the skin as the material gets hot during the drying process and cushions the skin against irritation from the splint.

Splint application lower extremity
Splint application

Steps to splint application

  1. Place the extremity in a position of natural function
  2. Wrap the extremity around the limb with stockingnette and layer 2-3 times with cotton padding
  3. Splinting material is placed over the joint or muscle to be supported while wet but not dripping with water
  4. Fold back the stockingnette and cotton padding to create a smooth edge (prevents injury)
  5. Wrap over the splint with elastic bandage from hand or foot upward, overlapping half of the width on the way.
  6. Secure elastic bandage with clips and tape over laying clips to avoid clips from slipping.

After Gabriel's splint has been applied, the staff in the ER gave him written and verbal instructions to care for his splint until a cast or boot will be applied in 7-10 days. Gabriel has not only the splint but crutches to assist him in keeping weight off the injured ankle.

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