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Thumb Spica Splint

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Other Names

Cast material shaped into the thumb spica mold.[1]
Plaster thumb spica splint with coban wrapped around it[2]
Prefabricated velcro thumb spica splint
  • Thumb Spica Splint
  • Thumb Spica Brace
  • Plaster Thumb Spica
  • Prefab Thumb Spica

Background

  • This page refers to the thumb spica splint
  • Splinting technique used to treat injuries of the thumb, carpal, and metacarpal[3]
    • Can be molded from plaster or splinting materials or made pre-fabricated

Indications


Contraindications

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

Procedure

Equipment

Preparation

  • Expose patient's skin where splint will be applied and perform neurovascular examination
  • Measure appropriate length of splint with stockinette
    • Splint should run the length of mid distal phalanx of thumb to mid forearm, with small amount of extra stockinette at end (approximately 2 inches on either end)
  • Measure appropriate length of plaster/ fiberglass based on stockinette length
  • Gather remainder of supplies and tub of warm water

Technique

  • Apply stockinette to affected forearm/ hand
  • Cut hole in stockinette for thumb with shears
  • Wrap two layers of cast padding over stockinette and add liberal amounts of padding over joints
  • Maintain patient's forearm in neutral position and wrist at approximately 25- 30° of extension
    • Have patient position hand as though they are holding a can of soda/beer
  • Wet plaster/ fiberglass with warm water and squeeze out excess water
  • Apply plaster/ fiberglass along radial aspect of forearm from mid distal phalanx of thumb to mid forearm
  • Mold plaster/ fiberglass to arm
  • Fold over excess stockinette ends over plaster/ fiberglass
  • Cut wedges into casting material at base of MCP with shears prior to molding
  • Apply Ace wrap over plaster/ fiberglass tightly
  • Continue to mold splint to arm until hardened
  • Reassess neurovascular exam of affected extremity after splinting completion

Aftercare

  • Arrange for outpatient follow up/ next visit
  • Maintain splint at all times
  • Keep splint clean and dry
  • Monitor for complications

Complications


See Also


References

  1. Image courtesy of AAFP.org, "Splints and Casts: Indications and Methods"
  2. Image courtesy of https://emedicine.medscape.com/, "thumb spica splinting"
  3. Shaw DC, Heckman JD. Principles and techniques of splinting musculocutaneous injuries. Emerg Med Clin North Am 1984; 2:391.
Created by:
Jesse Fodero on 10 July 2019 17:17:58
Last edited:
20 June 2023 16:41:11
Category: