We need you! See something you could improve? Make an edit and help improve WikSM for everyone.

Forearm Volar Splint

From WikiSM
Jump to: navigation, search


Other Names

Approximate landmarks for the volar forearm splint[1]
Demonstration of volar forearm splint.[2]
Step-by-step instructions for the volar slab splint[3]
Demonstration of the final splint[4]
  • Volar Splint
  • Dorsal Splint
  • Sandwich splint
  • Forearm Volar Slab

Background

  • This page refers to both dorsal and volar splints
    • Typically a volar splint is used
    • A dorsal slab can be applied for increased stability
  • Can be used as definitive treatment or temporary treatment before a cast is applied
  • Improves patient comfort, facilitates recovery, and protects from further injury
  • A forearm volar splint differs from a cast in that it is not circumferential
    • This allows for some swelling without constriction

Indications


Contraindications


Procedure

Equipment

Preparation

  • Length and application depend on the type of fracture
    • Typically extends from metacarpal heads to mid- or proximal forearm
    • Use about 8-10 layers of plaster of paris

Technique

  • Assess and confirm neurovascular status
  • Apply stockinette and smooth over the extremity with ~2cm extra proximally and distally
  • Wrap cast padding from the metacarpal head circumferential to the antenuptial fossa over stockinette (avoid wrinkles and gaps)
  • Supinate the wrist and hold it at ~20 degrees of extension
  • Splint application
    • Wet splitting material with lukewarm water and squeeze excessive water
    • Lay most material along the palmar aspect of the hand, wrist, and forearm to ~4cm proximal to the antecubital fossa
  • Once plaster takes form, apply cast padding above splinting material
  • Apply final layer of ACE bandage
  • Reassess neurovascular status and confirm fit patient

Pearls

  • Key anatomic positions
    • Forearm in neutral position with thumb up
    • Wrist in slight extension (10–20º)
    • Hand is in "holding a can" position

Aftercare

  • Try to elevate extremity for the first few days to prevent more swelling
  • Advise patient to keep cast or splint clean and dry
  • Do not insert objects into splint/ cast
  • Monitor for complications (worsening pain, paresthesia/ numbness, color changes)
  • Seek further care if unable to control pain at home

Complications

  • Thermal injury
    • Plaster/fiberglass and water cause an exothermic reaction
  • Skin sores, pressure ulcers, and blisters from excessive pressure
  • Ischemic injury if too tight
    • Can also contribute to compartment syndrome
  • Nerve palsy
  • Vascular compromise
    • Unlikely given splint only covers volar or dorsal surface
  • Splint dermatitis
  • Joint stiffness

See Also


References

  1. Garcia-Rodriguez, Juan Antonio, Peter David Longino, and Ian Johnston. "Forearm volar slab splint: Casting Immobilization Series for Primary Care." Canadian Family Physician 64.8 (2018): 581-583.
  2. Image courtesy of fpnotebook.com, "volar forearm splint"
  3. Image courtesy of NHS "Practical Guide to Casting", https://heeoe.hee.nhs.uk/sites/default/files/practical_guide_to_casting_0.pdf
  4. Image courtesy of youtube.com, "Volar Short Arm Splint - Proliance Orthopaedics & Sports Medicine"
Created by:
Jesse Fodero on 14 July 2019 20:32:35
Last edited:
13 June 2023 14:29:11
Category: