[Marburg shoulder radiography splint (MSR splint) for standardized and high quality plain film radiography in fractures of the proximal humerus]

Abstract

To ensure safe, quick, pain-relieving, standardized, and reproducible high quality plain film radiography in fractures of the proximal humerus, the MSR splint was introduced into clinical practice. With the rectangular and completely radiolucent splint the shoulder radiographs are obtained in supine position by a sole radiographer. Two radiographs are taken in projection at 90 degrees to one another: the true anteroposterior and axillary views, the most important views for fracture visualization and assessment. The smooth flat bottom part of the splint glides easily across the X-ray table below the injured shoulder. The arm lying on the chest is carefully rotated externally up to the neutral position and placed in the splint, then fixed with Velcro fastening with the forearm supinated. The splint is adjusted to the patient for the anteroposterior view which is taken with the central ray directed at the coracoid process and perpendicularly on the film cassette. For the axillary view the MSR splint holding the upper extremity is carefully swiveled into a 80-90 degrees abduction position. Even in cases of comminuted fractures this maneuver is not painful for the patients. The X-ray tube is put into a horizontal position with the central ray pointing to the humeral head in an angle about 25 degrees to the long body axis. The cassette is placed upright in touch with the shoulder girdle. In our institution the MSR splint is not only routinely used for diagnosing fractures of the proximal humerus but also for radiological follow-up controls.