Ankle Splinting Periprocedural Care

Updated: Dec 14, 2015
  • Author: Lars J Grimm, MD, MHS; Chief Editor: Erik D Schraga, MD  more...
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Periprocedural Care

Equipment

The equipment involved in ankle splinting includes the following (see the image below):

  • Stockinette
  • Padding (eg, Webril)
  • Ready-made plaster or fiberglass splinting material or plaster splinting material (eg, plaster of Paris), 10-12 sheets (15-20 sheets if the patient is allowed to bear partial weight), 4-6 in. wide
  • Bandage or wrap (eg, Bias bandage or ACE wrap), 3-4 in. wide
  • Clean, room-temperature water in a basin
  • Trauma shears or a pair of medical scissors without pointed ends
  • Disposable (Chux) pads and bed sheet
  • Tape (if using Bias bandage) or bandage clips (if using non-Velcro ACE wrap)
Equipment for splint. Image courtesy of Kenneth R. Equipment for splint. Image courtesy of Kenneth R. Chuang, MD.
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Patient Preparation

Anesthesia

Ankle splinting is usually tolerated without the use of anesthesia. However, if significant manipulation or reduction of the injury is required during the splinting process, one of the following anesthetic techniques may be used [3] :

  • Hematoma block or nerve block
  • Procedural sedation with appropriate monitoring and administration by an experienced practitioner [4] (for more information, see Procedural Sedation)
  • Oral or intravenous analgesics (eg, nonsteroidal anti-inflammatory drugs [NSAIDS], opioids)

With the administration of any analgesic agent or the initiation of a formal sedation protocol, care should be taken to avoid oversedation. A complete neurovascular examination should be performed before and after the splint has been applied.

Positioning

Place the patient comfortably in the prone position, with the affected limb in 90° of knee flexion (see the video below). Cover the patient with a sheet to avoid splatter from the wet plaster.

Position the patient prone, with knee flexed to 90 degrees. Cover the patient appropriately. Video courtesy of Kenneth R. Chuang, MD.
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