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Splinting

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Splinting Basics

  • Any suspected fracture (broken bone) or dislocation should be splinted, immobilized, or both. An effective splint helps to prevent further injury and to provide substantial pain relief.
  • Splints can be ready-made or can be made from basic materials. For example, a person could use branches, boards, layers of cardboard, or a foam sleeping pad. Wrapping materials for the splint can include bandannas, climbing webbing, torn shirts, pants, or other pieces of clothing. These materials should be wrapped completely around the splinted extremity to secure the splint but should not be so tight as to block circulation.
  • Unless the person who is injured is in a dangerous setting (for example, in the middle of a road or at the foot of a gully exposed to frequent ice or rock falls), all injuries should be splinted before the person is moved to minimize further injury.
  • Severely deformed fractured limbs should be straightened by a doctor if sensation or pulses are impaired prior to splinting. The process of straightening should not worsen the injury.
  • A basic rule of splinting is that the joint above and below the broken bone should be immobilized to protect the fracture site. For example, if the lower leg is broken, the splint should immobilize both the ankle and the knee.
  • Pulses and sensation should be checked below the splint at least once per hour. If the person complains of tightness, tingling, or numbness, the wrapping material should be released completely, and the splint should be rewrapped more loosely.

Upper Extremity Splinting: Arm, Shoulder, Elbow, Wrist, Finger

  • Using bandages to create a sling works for immobilizing collarbone, shoulder, and upper arm injuries extending down to the elbow. The arm sling is wrapped to the person's body with a large bandage encircling the person's chest.
  • Injury to the forearm and wrist requires a straight supportive splint that secures and aligns both sides of the injury. An open hardback book is a quick and handy, temporary immobilizer.
  • An injured finger can be buddy-taped to the adjacent, unaffected fingers, or it can be splinted with small pieces of wood or cardboard until more sturdy splints can be applied.

Lower Extremity Splinting: Pelvis, Hip, Leg, Knee, Ankle, Foot

  • Pelvis, hip, and femur (upper leg) fractures often completely immobilize the person. Because broken bones of the pelvis and upper leg can cause massive, life-threatening internal bleeding, people with these types of fractures should be evacuated unless splinting and carriage are absolutely necessary. In these cases, the splint should extend to the lower back and down past the knee of the affected side of the extremity.
  • Knee injuries require splints that extend to the hip and down to the ankle. These splints are applied to the back of the leg and buttock.
  • Ankle injuries and foot injuries can be wrapped alone. Use a figure-of-eight pattern: under the foot, over the top of the foot, around the back of the ankle, back over the top of the foot, under the foot, and so on. Splinting supports can also be used along the back and sides of the ankle to prevent excessive movement. The foot should be kept at a right angle in the splint to immobilize the ankle.
  • An injured toe can be buddy-taped to the adjacent, unaffected toes until evaluated by a health care professional.

Stress Fractures: Some Take Longer to Heal Than Others

Medical Author: Benjamin C. Wedro, MD, FAAEM
Medical Editor: William C. Shiel Jr., MD, FACP, FACR

It takes a lot of effort to support 7 feet 6 inches and the two tons of force generated when NBA basketball star Yao Ming walks or jumps. The cushioning that absorbs the shock of his weight rests on two feet and their joints, ligaments, and muscles. The force of that weight during running can multiply a person's weight by more than12 times. Unfortunately for the Houston Rocket basketball player, his bones couldn't withstand the constant pounding and he developed a stress fracture of the navicular bone of his foot.

The navicular bone helps support the arch of the foot and is a bridge between the bones of the ankle and those of the toes. The bony arch is also supported by the plantar fascia, the thick band of tissue that connects the heel to the front of the foot. The solid bones and the pliable ligaments flex the foot to disperse the forces generated with walking, running, and jumping. But if the force placed on the bone is greater than its ability to withstand it, small micro fractures can occur in the bones that can develop into a stress fracture.

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Reviewed on 11/20/2017
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