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Hand & Finger Splints: Ulnar Gutter & Radial Gutter

Instructor: Dan Washmuth

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

What is the difference between ulnar gutter and radial gutter splints? What types of injuries are these splints used for? Find out the answers to these questions, and so much more, by checking out this lesson.

Knockout Punch

Brent is an amateur boxer who is trying to turn professional and recently fought the defending champion in his weight class. During the fight, Brent threw a powerful uppercut punch that knocked his opponent out for the win. However, when Brent landed this knockout punch, he felt an intense pain in his ring and pinky fingers. Afterwards, Brent took off his gloves and saw that these two fingers had swollen up to more than three times their normal sizes.

Luckily, there was a doctor at the fight who was able to immediately take an x-ray of Brent's fingers, and these x-rays revealed that Brent had fractured both fingers. The doctor then put an ulnar gutter splint on his injury. The doctor instructed Brent to keep this splint on for the next few days and then come back and see him once the swelling goes away.

The bones in the hands are known as the metacarpals, and the bones in the fingers are known as phalanges. Fractures to these bones are fairly common, and often require a cast to be placed on the injury in order for it to properly heal. However, there is usually a lot of swelling the first few days following a fracture to these bones. Since casts enclose the entire forearm, wrist, and hand, they do not allow for additional swelling. Therefore, instead of putting a cast on these injuries immediately, a splint is usually applied until the swelling goes down. Once the swelling goes down, then the injury can then be put in a cast.

Two types of splints used to treat broken metacarpals and phalanges during the first few days following the injury are ulnar gutter and radial gutter splints.

Ulnar gutter and radial gutter splints are used to treat fractures to the metacarpals and phalanges in the hand
bones in hand

Ulnar Gutter Splints

Ulnar gutter splints are used for fractures and severe sprains to the fourth and fifth metacarpals and phalanges (ring and pinky fingers). This splint gets its name because these two fingers are on the ulnar side of the hand (the ulna is the bone on the pinky side of the forearm).

Ulnar gutter splints are made from a hard material that forms to the outer part (pinky side) of the arm, wrist, hand, and fingers. This splint usually extends from the upper part of the forearm to the last joint of the injured fingers. When ulnar gutter splints are applied, the wrist is bent slightly backwards and the injured fingers are flexed forward in a rounded position. The uninjured fingers are usually not splinted. The arm is then usually wrapped with an elastic bandage to help secure the splint and provide extra stability.

This medical professional is in the middle of applying an ulnar gutter splint to the arm of a person who has fractured his fourth and fifth metacarpals
ulnar gutter splint

Radial Gutter Splints

Radial gutter splints are used for fractures and severe sprains to the second and third metacarpals and phalanges (pointer and middle fingers). This splint gets its name because these fingers are on the radius side of the hand (the radius is the bone on the thumb side of the forearm).

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