Stirrup Ankle Splint

Other Names

• Stirrup Splint
• Sugar Tong Ankle Splint

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Background

Illustration of Stirrup Splint

Example of stirrup splint

• This page refers to the stirrup splint
  • Short leg splint running under heel and foot from medial to lateral leg, extending to level of fibular head on both sides.
  • Essentially the "sugar tong" of the ankle
• Typically applied along with posterior short leg splint

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Indications

Stable Injuries

• Ankle
  • Ankle Sprain if severe enough
  • Distal Fibula Fracture
  • Distal Tibia Fracture
  • Achilles Tendon Rupture (in slight plantar flexion)
• Foot
  • Stable Talus Fracture
  • Stable Lisfranc Injury
  • Metatarsal Fracture

Unstable requiring addition of Stirrup Splint

• Ankle
  • Ankle Fracture (& Dislocation)
  • Subtalar Dislocation
• Foot
  • Unstable Lisfranc Injury

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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

• Document pulse, motor, sensation
• Measure plaster length
  • Start: At level of fibular head laterally
  • End: At level of fibular head on medial side of leg
  • Use 10-12 layers for lower extremity

Technique

• Number of people
  • Typically, at least 2
• Patient Position
  • Knee is bent to 90°
  • Ankle is at 90°
• Stockinette
  • Apply stockinette slightly longer than desired splint length
• Web roll/ cotton padding
  • Apply cotton padding starting proximally and working distally
  • Apply extra padding around calcaneus
• Splint material
  • Immerse splinting material in lukewarm water, squeeze out excess water
  • Apply wet plaster in U-shape from fibular head, around calcaneus and up medial calf to roughly the same height
• Can apply more cast padding
• Apply ace wrap/ elastic wrap
• Hold in place until hardened
• Confirm the distal neurovascular status

Pearls and Pitfalls

• Splint is much easier to apply if patient is prone
• If injury is unstable, holding reduction is key during splinting and hardening process

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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

• Acute Compartment syndrome
• Plaster burn/ thermal injury
• Pressure sores
• Nerve palsy
• Vascular compromise
• Splint dermatitis
• Permanent joint stiffness
• Skin infection
  • Cellulitis from underlying wound, pressure ulcers

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See Also

• Ankle Pain Main
• Foot Pain Main
• Procedures Main
• Splinting Main

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