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Elbow & Forearm Splints: Long Arm Posterior & Double Sugar-Tong

Instructor: Dan Washmuth

Dan has taught college Nutrition, Anatomy, Physiology, and Sports Nutrition courses and has a master's degree in Dietetics & Nutrition.

Elbow and forearm injuries are quite common and there are several types of splints that can be used to treat these types of injuries. Prepare to learn all about two types of these splints: long arm posterior and double sugar-tong splints.

Be Careful on the Roof!

Jake is a 43-year-old who was cleaning his roof and gutters one recent Saturday afternoon. While he was bending over to reach into his gutters, Jake lost his balance and fell about eight feet to the ground, landing on his right arm. As he landed, he heard a loud ''pop'' in his elbow and felt an intense pain.

Jake was pretty certain that he injured his elbow quite badly, so he drove himself to the hospital to get his arm evaluated. After taking multiple x-rays of Jake's arm and elbow, the doctor informed Jake that he had fractured the olecranon process of his elbow. To prevent further injury and help immobilize the elbow joint, the doctor put his elbow in a splint called a long arm posterior splint and told him to come back in five days to be reevaluated.

The Elbow Joint

The elbow joint is made up of three main bones: humerus (bone of the upper arm), radius (bone on the thumb side of the forearm), and ulna (bone on the pinky side of the forearm). The olecranon process is a bony prominence at the top of the ulna that forms the ''point'' of the elbow. There are several different ligaments, tendons, and muscles that help keep these bones in their normal positions while a person moves this joint around. Two specific splints for injuries to the elbow and forearm are the long arm posterior splint and the double sugar-tong splint.

Long arm posterior and double sugar-tong splints are used for injuries and fractures to the elbow joint and forearm.
elbow joint

Long Arm Posterior Splint

A long arm posterior splint is applied to the underside of the arm while the arm is bent at a 90 degree angle. This plate extends from the axilla (armpit) all the way to the proximal palmar crease (the large middle crease in the palm of the hand). Long arm posterior splints are commonly used for the following injuries:

  • Fractures to the humerus near the elbow
  • Fractures of the radius and ulna near the elbow
  • Fractures to the olecranon process
  • Injuries that result in major damage to the ligaments of the elbow

This type of splint is often used for the first few days following the injury, because it allows room for additional swelling of the injury (a cast that surrounds the entire arm does not allow for increased swelling). Usually, long arm posterior splints are applied to the injured arm for the first 1-5 days following the injury. After 1-5 days, the injury is reevaluated by a physician. At this time, the physician may choose to perform surgery, cast the arm, or continue using the splint.

This is an x-ray of an olecranon fracture, an injury that is commonly treated using a long arm posterior splint.
olecranon fracture

Double Sugar-Tong Splint

A double sugar-tong splint consists of two U-shaped splints. With the elbow bent at a 90 degree angle, one of these U-shaped splints fits under the elbow and extends up both sides of the forearm until it reaches the base of the fingers. The other U-shaped splint is then placed on the upper arm, going under the elbow and extending up the arm until it reaches the bottom of the deltoid (shoulder) muscle. Double sugar-tong splints are most commonly used for the following injuries:

  • Fractures of the radius and ulna near the elbow
  • Fractures to the olecranon process
  • Colles fractures (fracture to the bottom of the radius, near the hand)

Just like the long arm posterior splint, double sugar-tong splints are often used in the initial days following the injury to allow for the injury to swell. After several days of wearing the double sugar-tong splints, the injury should be reevaluated by a physician to determine long term care and treatment.

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