Quick refreshers before your next procedure

Arm Splints

Thumb Spica Splint

Inner:
1. Stockinette 
2. Padding 

Middle: 
1. 8-10 layers of plaster or Fiberglass 

Outer:
1. Padding 
2.Elastic Bandaging 

Steps: 

  1. Measure the length of plaster/fiberglass to cut by starting at the thumb's mid-distal phalanx to the mid-forearm.
  2. If using fiberglass, allow an extra 1 cm of padding to overhang over the casting material to ensure soft edges. 
  3. Apply a small 1 inch stockinette to the thumb with excess length over the thumb and the wrist.
  4. Cut the thumb stockinette at the base to allow a snug fit over the palms.
  5. Apply a new 2 inch stockinette to extend 5-10 cm beyond the splinting material over the arm.  
  6. Apply padding layers over the stockinette in a circumferential pattern with 30 - 50% overlap of the preceding layer. 
  7. Wet the plaster or fiberglass under water. If using plaster, squeeze out excess water to leave it moistened. 
  8. Mold the plaster/fiberglass at the thumb's mid-distal phalanx to the mid-forearm.
  9. Keep thumb in a neutral position with mild 10 degree flexion
  10. Keep forearm in neutral position 
  11. Wrist in 10 - 20 degree extension (as if holding a can). 
  12. If using plaster, apply an external layer of padding over the splint. 
  13. Roll the stockinette over the splinting material.
  14. Apply elastic bandaging in a circumferential pattern with 30 - 50% overlap of the preceding layer.
  15. Start at the wrist and wrap around the thumb and then around the wrist.
  16. Mold the splint in a 3 point mold. 

Sugar Tong Arm Splint

Inner:
1. Stockinette 
2. Padding 

Middle: 
1. 8-10 layers of plaster or Fiberglass 

Outer:
1. Padding 
2.Elastic Bandaging 

Steps: 

  1. Measure the length of plaster/fiberglass to cut by starting at the volar MCP -> around elbow -> dorsal MCP
  2. If using fiberglass, allow an extra 2 cm of padding to overhang over the casting material to ensure soft edges. 
  3. Apply stockinette to extend 5-10 cm beyond the splinting material over the arm; cut holes for finger holes as needed. 
  4. Apply padding layers over the stockinette in a circumferential pattern with 30 - 50% overlap of the preceding layer. 
  5. Wet the plaster or fiberglass under water. If using plaster, squeeze out excess water to leave it moistened. 
  6. Mold the plaster/fiberglass at the volar MCP -> around elbow -> dorsal MCP. 
  7. Keep elbow at 90 degrees flexion 
  8. Keep forearm in neutral position 
  9. Wrist in 10 - 20 degree extension (as if holding a can). 
  10. If using plaster, apply an external layer of padding over the splint. 
  11. Pull the stockinette over the splinting material. Ask the patient to help support.
  12. Apply elastic bandaging in a circumferential pattern with 30 - 50% overlap of the preceding layer.
  13. Mold the splint in a 3 point mold. 
  14. The 3 point mold for a Colles would be 
    Point 1: Proximal volar forearm 
    Point 2: Fx site dorsal aspect 
    Point 3: Distal volar joint space