Long Leg Posterior Splint

Other Names

Illustration of the posterior long leg splint

Posterior long leg splint with plantar foot extension, which blocks plantarflexion and most ankle movement

Illustration of the final posterior long leg splint

• Long Leg Posterior Splint
• Posterior Long Leg Splint
• Posterior Knee splint
• Temporary long leg splint

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Background

• This page describes the posterior long leg splint
• Generally considered a temporizing splint until definitive management
• In many cases, a knee immobilizer is a suitable and simpler alternative
  • Knee immobilizer may be insufficient due to swelling or patient body habitus

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Indications

• Stabilization of acute soft tissue injuries
  • Quadriceps Tendon Rupture
  • Patellar Tendon Rupture
  • Anterior Cruciate Ligament Rupture
• Patellar Fracture
• Patellar Dislocation
• Tibial Plateau Fractures
• Distal Femur Fractures
• Proximal Fibula Fractures

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Contraindications

• Absolute contraindications
  • None
• Relative contraindications
  • Open fractures
  • Injuries with neurovascular compromise

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Procedure

Equipment

• See: Splinting Materials

Preparation

• Measure plaster/ splinting material
  • Splint begins just below gluteal crease and ends just proximal to the malleoli
  • 10-12 layers should be used

Technique

• Patient Position
  • The knee is positioned in slight flexion
• Stockinette
  • Apply stockinette slightly longer than desired splint length
• Web roll/ cotton padding
  • Apply cotton padding starting proximally and working distally
• Splint material
  • Immerse splinting material in lukewarm water, squeeze out excess water
  • Apply the splint material along posterior leg
• Fold the extra stockinette and cotton padding over the edges of the splinting material.
• Elastic Wrap
  • Wrap the elastic wrap over the splinting material distally to proximally
  • Overlap each revolution by half the width of the elastic wrap
• Smooth out the splinting material
• Use your palms rather than your fingertips to conform to the contour of the arms
• Confirm the distal neurovascular status

Pearls and Pitfalls

• If ankle immobilization is necessary, as with tibial shaft injuries, the splint should extend to include the metatarsals.
• The splint can also be extended down the the plantar foot as clinically indicated
  • This is typically reserved for injuries below the knee

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Aftercare

• Typically non-weight bearing until re-evaluated
• 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

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Complications

• Plaster burn/ thermal injury
• Pressure sores
• Nerve palsy
• Vascular compromise
• Splint dermatitis
• Permanent joint stiffness

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See Also

• Procedures Main
• Splinting Main

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