Splinting

Excerpt

Musculoskeletal injuries are prevalent, and injured patients may present to emergency departments or urgent care, primary care, or specialty clinics. The initial management of an acute traumatic limb injury includes obtaining a comprehensive medical history and performing a physical examination, paying particular attention to the neurovascular status of the affected limb.

Injuries resulting in instability require immobilization to decrease the likelihood of further damage, protect soft tissues, alleviate pain, and accelerate healing. Instability may result from injury to the bones, joints, or musculature. A splint may be the best immediate treatment option for an unstable injury; sometimes, a splint may be the definitive treatment option.

A splint is loosely defined as an external device used to immobilize an injury or joint and is most often made out of plaster or fiberglass. Various splinting techniques may be employed, dictated by the location of the injury and the position of immobilization needed. Splinting aims to correct and restore the anatomic length, rotation, and angulation of a specific injury.

Splinting is not a benign procedure; malpositioning can cause undue pain, malreduction, and skin breakdown. Improper splinting will necessitate replacement. Splint-related soft tissue complications are the second most common iatrogenic cause for referral to plastic surgery. Poor splinting techniques are common, with one study demonstrating inappropriate splinting on 93% of patients. A thorough understanding of the indications, contraindications, and approach to proper splint placement is essential for practitioners that treat patients with acute musculoskeletal injuries.