PL AYI NG I N PL AST E R T HE BASI CS OF SPL I NT I - PowerPoint PPT Presentation

PL AYI NG I N PL AST E R – T HE BASI CS OF SPL I NT I NG K a ri M. K o mlo fske , F NP-C & Jo hn Wo rking e r, F NP-C

OBJE CT I VE S  T o de mo nstra te a n inc re a se d a b ility in ide ntifying va rio us type s o f fra c ture s  Unde rsta nd the va rio us splinting o ptio ns; c ho o sing the a ppro pria te splint fo r a g ive n fra c ture  E va lua te a nd unde rsta nd splint a pplic a tio n  Disc uss multiple me dic a tio ns use d in tre a tme nt o f o rtho pe dic injurie s

WHY SPL I NT  T o sta b ilize a fra c ture  Assist in ma king a pa tie nt mo re c o mfo rta b le  Pro mo te va sc ula riza tio n  Pre ve nt wo und o r tissue c o mpro mise  T ra nspo rta tio n

F ra c ture s  Ope n o r Clo se d fra c ture  Ope n – A fra c ture tha t b re a ks thro ug h the skin T his fra c ture sho uld ha ve imme dia te re fe rra l to o rtho pe dic s (ma y ne e d to g o to the o pe ra ting ro o m)  Clo se d – A fra c ture tha t is c o nta ine d in the skin L o o k fo r va sc ula r c o mpro mise a nd skin te nting

Displa c e d o r No n-Displa c e d?  DI SPL ACE D  NON-DI SPL ACE D

SPL I NT T YPE S  Ulna r Gutte r  T humb Spic a  Sug a r T o ng  F ing e r Splint  Do rsa l F o re a rm  Sho rt L e g Splint

UL NAR GUT T E R  Ulna r Gutte r Splint - is use d to suppo rt, sta b ilize a nd immo b ilize dislo c a tio ns a nd fra c ture s o f the ha nds, fing e rs o r wrists.

T HUMB SPI CA  T humb Spic a -- immo b ilize the thumb a nd/ o r wrist while a llo wing o the r dig its fre e do m to mo ve . I t pro vide s suppo rt fo r thumb injurie s (lig a me nt insta b ility, spra in o r musc le stra in), g a me ke e pe r's thumb , o ste o a rthritis, de Que rva in's syndro me , e , thumb spra ins. sc aphoid fr ac tur

SUGAR T ONG  SUGAR T ONG -- splinting fra c ture s o f the ra dius, ulna , o r wrist. I t pre ve nts fle xio n a nd e xte nsio n a t the wrist, limits fle xio n a nd e xte nsio n a t the e lb o w, a nd pre ve nts supina tio n a nd pro na tio n.

F I NGE R SPL I NT  F I NGE R SPL I NT -- c a n b e use d to tre a t a va rie ty o f c o nditio ns fro m ma lle t fing e r a nd a rthritis to swa n ne c k de fo rmity.

DORSAL F ORE ARM  DORSAL F ORE ARM -- So ft tissue injurie s o r fra c ture s o f the ha nd a nd wrist Ca rpa l b o ne fra c ture s, 2nd – 5th MC he a d fra c ture s  Splint -Sta rts in the pa lm a t the MC he a ds, do wn the vo la r a spe c t o f fo re a rm to dista l fo re a rm

Sho rt L e g Splint  Se ve re a nkle spra ins  F ra c ture s o f dista l fib ula a nd tib ia  Re duc e d a nkle dislo c a tio ns

OT HE R F RACT URE S:  CL AVI CL E  HUME RUS  F E MUR  HI P  E L BOW

DI SCUSSI ON  Co nc e rns  Swe lling  Circ ula tio n  Alig nme nt  Po sitio ning  Co mfo rt - Suppo rt  PAI N ME DI CAT I ON

Swe lling , fra c ture b liste rs – c a use pro b le ms….

Pha rma c o lo g ic a l o ptio ns  Ac e ta mino phe n  AVOI D NSAI DS in a c ute F RACT URE S  Musc le re la xa nts – fle xe ril, ske la xin  Na rc o tic s – No rc o , pe rc o c e t, o xyc o do ne , dila udid, mo rphine  I mme dia te re le a se ve rsus e xte nde d re le a se

No n-pha rma c o lo g ic a l o ptio ns  He a t  I c e  E le va tio n  Ma ssa g e  Ac upunc ture  Chiro pra c to r

SPL I NT I NG SUPPL I E S Sto c kine tte Pla ste r o f Pa ris Strips o r ro lls (2-, 3-, 4- o r 6-inc h widths) Pre fa b ric a te d Splint Ro lls Pla ste r F ib e rg la ss with po lypro pyle ne pa dding Pa dding (We b ril) Ac e Wra p Buc ke t/ re c e pta c le o f wa rm wa te r T ra uma she a rs

PROCE DURE Sto c kine tte is a pplie d (o ptio na l) We b ril is a pplie d T he we t pla ste r is po sitio ne d We b ril o n o utside E la stic b a nda g e is a pplie d T he pla ste r is mo lde d

L E T ’ S PL AY WI T H PL AST E R

My Da ug hte r Britta ny 20 ye a rs o ld

My so n Ja c kso n 17 ye a rs o ld

So I ha ve to do this…

RE F E RE NCE S  Sa rwa rk, Jo hn, F . (2010). E sse ntia ls o f Musc ulo ske le ta l Ca re 4. Ro se mo nt, I L : Ame ric a n Ac a de my o f Ortho pa e dic Surg e o ns.  Sto lle r, Da vid, W. (2008). Sto lle r's Atla s o f Ortho pa e dic s a nd Spo rts Me dic ine . Ba ltimo re , MD: L ippinc o tt Willia ms & Wilkins, a Wo lte rs K luwe r b usine ss. Bic kle y, L ynn, S. (2007).  Ba te s' Guide to Physic a l E xa mina tio n a nd Histo ry T a king , 9th e d. Phila de lphia , PA: L ippinc o tt Willia ms & Wilkins