Background
Splinting techniques are used to treat musculoskeletal system abnormalities. The main indications for splinting are to temporarily immobilize a limb for pain and spasm, to decrease swelling, and to minimize further potential soft-tissue or neurovascular injuries associated with contusions, sprains, lacerations, fractures, dislocations, or painful joints due to inflammatory disorders. [1, 2, 3, 4, 5, 6]
Indications
Indications for splinting include the following:
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Control of pain
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Prevention of further soft-tissue or neurovascular injuries
The American Academy of Orthopaedic Surgeons (AAOS) found strong evidence to support the use of splints in the treatment of carpal tunnel syndrome (CTS). [10]
The multicenter Postoperative Ankle Splint Trial (PAST) did not find routine splinting to add any perceivable benefit to the postoperative course after ankle fracture fixation. [11] Refraining from splinting did not lead to higher complication rates; rather, it led to a greater frequency of unplanned emergency department (ED) visits and lower early satisfaction rates.
Contraindications
There are no absolute contraindications for the use of splints in the ED or in the field to stabilize for transport. For use as a temporary immobilizing device either until follow-up (eg, for stable fractures) or until definitive treatment can be performed (eg, ankle fractures), relative contraindications include the following:
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Impending compartment syndrome
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Neurovascular compromise
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Developing or active reflex sympathetic dystrophy
Outcomes
Soft-tissue injuries
Although splinting is a common initial treatment for CTS, the evidence of its efficacy as a standalone treatment is weak. [12] Electrophysiologic assessment is under investigation as a tool to aid in the selection of patients who would receive the greatest benefit from splinting. [13]
A study of nighttime splinting for 6 weeks as treatment for recent-onset idiopathic trigger fingers reported complete resolution of symptoms in 55% of patients. [14] A thumb spica splint relieves the symptoms of de Quervain tendinopathy, but symptoms improve more rapidly when it is combined with corticosteroid injections. [12, 15]
A comparison of short-duration wrist-joint splinting plus physical therapy with physical therapy alone for the treatment of lateral epicondylitis ("tennis elbow") found significantly greater improvement in pain intensity, wrist flexion range of motion (ROM), and grip strength with the former. [16]
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Ossur OrthoRoll.
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Ossur OrthoRoll applied.
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Premanufactured splint.
