Application of Splints

Objectives
To immobilize the joint and prevent further tissue injury (including neurovascular injury). To immobilize a fractured limb and maintain good functional alignment. To relieve pain and spasms. To improve circulation. To decrease blood loss. To reduce the risk of fat emboli.

NOTE: Provides temporary immobilization.

Types: Wood Splints 1. Splint board- used as a brace across both legs on bilateral hip spica or as a brace for the arm on a shoulder spica. Placed under the heel of a cast at right angles to te leg to prevent rotation.

 Plaster Splints 1. Plaster splint six or more thickness of plaster of desired width are used. Measure length of the limb with a strip of sheet wadding and the splint made of fan folding layers of plaster this length from bandage rolls. One roll is used for a short splint, two rolls for a long splint. It is folded, immersed in water, and extra water wrung. It is applied to the posterior part of the limb and bandage with the gauze or cotton elastic bandage. It maybe used for fracture of ulna or fibula.

 2. Hairpin or sugar-tong splint- a splint twice as long as the lower arm and hand is used. After the plaster is soaked, it may be covered with stockinette. Starting with the one end of it on the back of the hand, it is placed around the flexed elbow, and the palm of the hand and the fingers rest on the other end of it. It is bandaged on. It is used for fracture of he ulna and radius. Soft immobilizers- such as elastic bandages, cardboard splints, foam splints.

Nursing Responsibilities:
1. Splint must be well padded to prevent pressure, skin abrasion, and skin breakdown. 2. When applying elastic bndage, apply in spiral fashion with the pressure distributed so that circulation is not restricted.

3. Assess neurovascular status and skin integrity of the splinted extremity. Assess color, temperature, pulse, and blanching of the nail bed. If there is evidence of neurovascular compromise, the splint is removed and reapplied. 4. To apply splint to fracture, one hand is placed beneath the fracture for support. The splints should extend beyond the joints adjacent to the fracture. Upper extremities must be splinted in functional position.

Nurse Alert
Watch out for compartment syndrome, pressure sores, heat injury, infection and joint stiffness.