Knee Splints: Posterior Knee & Off-The-Shelf Immobilizer

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.

Knee injuries usually need rest to heal. This lesson will discuss the use of knee splints and immobilizers to allow healing and prevent re-injury. The patient will need instructions for care using these devices.

Knee Injury

Greta, a 40-year-old arthritis patient, fell off her porch trying to reach her dog. The impact on the steps and the ground caused severe pain to her right knee, and while able to move only slightly, she was able to call 911.

Knee injuries can be found in the urgent care and emergency department of hospitals many times a week. As in Greta's case, falls or blunt force trauma are common causes of injury along with twisting movements. Both involve abnormal force applied to the knee or abnormal movement.

Knowing the mechanism of injury, or how the injury occurred, can lead the healthcare professional to the possible injury site, and will be a determining factor in the type of splint used. The knee can sustain sprains, strains, fracture or breaking of a bone, and inflammatory response, such as bursitis (inflammation of the bursa.) The inflammatory response is painful and is due to overuse or abuse of the knee, or direct blows. Because of the close proximity of muscle, bone, ligaments and tendons in the knee, injuries can occur to many areas of the knee at once.

Knee anatomy

Treatments for Knee Injuries

Greta has a fractured patella, or knee cap, and, like most knee injuries, hers can be treated with either a knee immobilizer or a posterior knee splint.

Knee Immobilizers

Knee immobilizers are prefabricated for quick splinting of the knee. They wrap around the leg and use three panels for support of the knee and can be used for fractures, strains, or sprains. It's an easy splint to apply, but an immobilizer should not be worn for long periods of time as it can cause muscle stiffness.

The patient's height will determine the best size for the knee immobilizer. Placing the immobilizer correctly with the wrapping Velcro makes the patient more comfortable as the straps can be adjusted. All skin must be intact or cleaned, sutured, and dressed prior to placing the immobilizer on the patient. After application, the patient's skin should be pink, warm, and dry below the splint.

Posterior Knee Splints

Posterior splints can also be used for fractures, sprains, and strains of the knee and its supporting structures. Posterior knee splints are formed to the leg by applying plaster-type material over padding to the area. More intense work is required for this splint as the leg needs to be measured, wrapped with padding, and wrapped again with wet material over the padding. Finally, an elastic bandage covers the length of the splint to support the splint as it forms.

Long leg splint
Splint on leg

The splint should be completely dry in 24-48 hours; it cannot get it wet, or it will disintegrate. Additionally, patients should not allow sharp surfaces to come into contact with the drying splint as indentations can harm the skin.

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