eMedicine Specialties > Clinical Procedures > Musculoskeletal Procedures

Splinting, Radial Gutter

Author: Lynne McCullough, MD, FACEP, Associate Professor of Medicine and Emergency Medicine, Geffen School of Medicine at UCLA; Medical Director, Westwood Emergency Department
Contributor Information and Disclosures

Updated: Sep 9, 2009

Introduction

In general, splints are applied to decrease movement and provide support and comfort by stabilizing an injury. Splints are primarily used to secure nonemergent injuries to the bones and soft tissues of an extremity until it can be evaluated by a consultant such as an orthopedic surgeon. Splints can also be used to assist in primary healing or to temporarily immobilize an extremity prior to surgery (eg, open fracture).1  Unlike casts, splints are noncircumferential and often preferred in the emergency department setting, since injuries are often acute and continued swelling can occur. All patients with injuries that are splinted should be referred for evaluation by a consultant in a timely fashion (usually within 2-7 days, depending on the reason for splinting).

Radial gutter splint. Image courtesy of Kenneth R...

Radial gutter splint. Image courtesy of Kenneth R. Chuang, MD.

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Radial gutter splint. Image courtesy of Kenneth R...

Radial gutter splint. Image courtesy of Kenneth R. Chuang, MD.



For information on surgical treatment of such injuries, see eMedicine articles Carpal Fractures; Metacarpal Fractures; Radius, Distal Fractures; Hand, Metacarpal Fractures and Dislocations; and Hand, Phalangeal Fractures and Dislocations.

Indications

A radial gutter splint can be used for various injuries that include the following:

  • Soft tissue injuries to the second and third fingers
  • Fractures of the second and third metacarpals
  • Fractures of the second and third phalanges
  • Positioning for rheumatoid arthritis
  • Laceration over the joints of the second and third phalanges or metacarpals

Contraindications

  • Absolute contraindications - None
  • The following injuries require immediate evaluation or intervention by a consultant (eg, orthopedic surgeon, hand surgeon, plastic surgeon) and should not be treated with splinting alone:
    • Complicated fractures
    • Open fractures
    • Injuries with associated neurovascular compromise

More on Splinting, Radial Gutter

Overview: Splinting, Radial Gutter
Treatment & Medication: Splinting, Radial Gutter
Multimedia: Splinting, Radial Gutter
References
Further Reading
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References

  1. Howes DS, Kaufman JJ. Plaster splints: techniques and indications. Am Fam Physician. Sep 1984;30(3):215-21. [Medline].

  2. Sacchetti A, Senula G, Strickland J, Dubin R. Procedural sedation in the community emergency department: initial results of the ProSCED registry. Acad Emerg Med. Jan 2007;14(1):41-6. [Medline].

  3. Kaplan SS. Burns following application of plaster splint dressings. Report of two cases. J Bone Joint Surg Am. Apr 1981;63(4):670-2. [Medline].

  4. Halanski MA, Halanski AD, Oza A, Vanderby R, Munoz A, Noonan KJ. Thermal injury with contemporary cast-application techniques and methods to circumvent morbidity. J Bone Joint Surg Am. Nov 2007;89(11):2369-77. [Medline].

  5. Hutchinson MJ, Hutchinson MR. Factors contributing to the temperature beneath plaster or fiberglass cast material. J Orthop Surg Res. Feb 25 2008;3:10. [Medline].

  6. Chudnofsky C, Byers S. Splinting techniques. In: Roberts J, Hedges J. Clinical Procedures in Emergency Medicine. 4th. Philadelphia: WB Saunders Company; 2004:989.

  7. Menkes J. Initial evaluation and management of orthopedic injuries. In: Tintinalli J, Kelen G, Stapczynski J. Emergency Medicine: A Comprehensive Study Guide. 6th. New York: McGraw-Hill Professional; 2003:1651.

  8. Playe SJ, Filener WS. Principles of Splinting. In: Hart RG, Rittenberry TJ, Uehara DT. Handbook of Orthopaedic Emergencies. Philadelphia, Pa: Lippincott-Raven; 1999:92-115.

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Keywords

radial gutter, radial gutter splint, splint pictures, splint video, splint demo, splint demonstration, splint technique, metacarpal fracture, splinting, hand fracture, broken hand, splint, hand splint, plaster of paris, plaster splint, ace bandage, drying plaster, finger swelling, metacarpal swelling, splint, radial splint, broken metacarpal, broken finger, thermal burn, decreased ROM, range of motion, pressure sore, ischemia, fracture, MCP, PIP, DIP, median nerve, radial nerve, hand injury

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Contributor Information and Disclosures

Author

Lynne McCullough, MD, FACEP, Associate Professor of Medicine and Emergency Medicine, Geffen School of Medicine at UCLA; Medical Director, Westwood Emergency Department
Disclosure: Nothing to disclose.

Medical Editor

Andrew K Chang, MD, Associate Professor, Department of Emergency Medicine, Albert Einstein College of Medicine, Montefiore Medical Center
Andrew K Chang, MD is a member of the following medical societies: American Academy of Emergency Medicine, American Academy of Neurology, American College of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

Managing Editor

Luis M Lovato, MD, Associate Clinical Professor, David Geffen School of Medicine at UCLA; Director of Critical Care, Department of Emergency Medicine, Olive View/UCLA Medical Center
Luis M Lovato, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

CME Editor

Gil Z Shlamovitz, MD, Assistant Professor of Emergency Medicine, University of Connecticut School of Medicine; Attending Physician, Emergency Department, Windham Community Memorial Hospital, Willimantic, CT; Attending Physician, Emergency Department, Hartford Hospital, Hartford, CT
Gil Z Shlamovitz, MD is a member of the following medical societies: American Academy of Emergency Medicine and American College of Emergency Physicians
Disclosure: Nothing to disclose.

Chief Editor

Erik D Schraga, MD, Consulting Staff, Department of Emergency Medicine, Mills-Peninsula Emergency Medical Associates; Consulting Staff, Permanente Medical Group, Kaiser Permanente, Santa Clara Medical Center
Disclosure: Nothing to disclose.

 
 
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