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Radial Gutter Splint

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Other Names

Illustration of the radial gutter splint
Splint position for the radial gutter splint[1]
Final product of the radial gutter splint[2]
A prefabricated radial gutter brace[3]
  • Radial Gutter Splint


  • This page covers the radial gutter splint
  • This prevents flexion/extension of the 2nd/3rd DIP, PIP, MCP, and wrist joints



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




  • Measure splint
    • Start at mid-radial forearm
    • Extend down beyond distal interphalangeal joint


  • Patient position
    • Forearm in neutral position
    • Wrist in approximately 20° of extension
    • MCP flexed 50-70° (some sources say up to 90°)
    • DIP and PIP slightly flexed at 5°–10°
  • Stockinette
    • Cut hole in stockinette for the thumb
    • Extend over second and third digit up forearm
  • Cast padding
    • Place between 2nd and 3rd digit
    • Wrap up and down forearm, sparing thumb and 4th/5th digit
  • Splint application
    • Apply splint folded over the radial forearm extending distally to the distal phalanx
    • It should cover approximately half of the dorsal and volar surface
    • Cut a hole for the thumb
  • Wrap stockinette over splint and cast padding
  • Apply ace wrap bandage
  • Recheck neurovascular exam


  • 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


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

See Also


  1. Image courtesy of youtube.com, "Radial Gutter Splint application"
  2. Image courtesy of AAFP.org, "Splints and Casts: Indications and Methods"
  3. Image courtesy of /www.djostore.com.au
Created by:
Jesse Fodero on 10 July 2019 18:27:36
Last edited:
28 July 2023 15:09:12