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Long Leg Posterior Splint

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Other Names

Illustration of the posterior long leg splint
Posterior long leg splint with plantar foot extension, which blocks plantarflexion and most ankle movement[1]
Illustration of the final posterior long leg splint[2]
  • Long Leg Posterior Splint
  • Posterior Long Leg Splint
  • Posterior Knee splint
  • Temporary long leg splint

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

Indications


Contraindications

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

Procedure

Equipment

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

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

Complications

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

See Also


References

  1. Image courtesy of EMRAP
  2. Image courtesy of https://surgeryreference.aofoundation.org/, "Temporary long leg splint"
Created by:
Jesse Fodero on 10 July 2019 18:55:59
Authors:
Last edited:
25 June 2023 13:20:43
Category: