Radial Gutter Splint

Other Names

2nd or 3rd proximal and middle phalanx fractures
- Nondisplaced, nonrotated
2nd or 3rd metacarpal fractures
- Nondisplaced fractures of the head, neck, and shaft
- Without significant angulation or rotation
Nondisplaced Distal Radius Fracture
Soft tissue injuries in the same distribution

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

Equipment

Preparation

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

Technique

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

Created by:

Jesse Fodero on 10 July 2019 18:27:36

Authors:

Last edited:

28 July 2023 15:09:12

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