Background
Splints are generally applied to decrease movement to provide support and comfort through stabilization of an injury. In the emergency department (ED), splints are primarily used to stabilize nonemergency injuries to bones until the patient can be evaluated by a consultant such as an orthopedic surgeon, at which time definitive casting can be performed. [1, 2, 3] Splints can also serve as initial immobilization in the preoperative period or can immobilize an injury for primary healing.
All patients with injuries that are splinted should be referred for evaluation by a consultant in a timely fashion (within 2-3 days). [4, 5]
Indications
A posterior elbow splint is primarily used to stabilize the following injuries:
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Fractures or soft-tissue injuries of the proximal radius or ulna that require immobilization of the wrist and elbow
Contraindications
Although no true contraindications exist for the placement of a splint, certain injuries require immediate evaluation or intervention by a consultant (eg, orthopedic surgeon, hand surgeon, or plastic surgeon) and, as such, may not necessitate splinting. Such injuries include the following:
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Complicated fractures
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Open fractures
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Injuries with associated neurovascular compromise
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Posterior elbow splinting. Equipment for splint. Image courtesy of Kenneth R Chuang, MD.
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Posterior elbow splinting. Cover patient appropriately. Video courtesy of Kenneth R Chuang, MD.
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Posterior elbow splinting. Remove jewelry and rings to avoid ischemia from swelling. Video courtesy of Kenneth R Chuang, MD.
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Posterior elbow splinting. Stockinette application. Video courtesy of Kenneth R Chuang, MD.
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Posterior elbow splinting. Cotton padding application. Video courtesy of Kenneth R Chuang, MD.
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Posterior elbow splinting. Measuring dry plaster. Video courtesy of Kenneth R Chuang, MD.
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Posterior elbow splinting. Wetting plaster. Video courtesy of Kenneth R Chuang, MD.
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Posterior elbow splinting. Applying wet plaster. Video courtesy of Kenneth R Chuang, MD.
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Posterior elbow splinting. Applying bandage wrap. Video courtesy of Kenneth R Chuang, MD
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Posterior elbow splinting. Molding of splint. Video courtesy of Kenneth R Chuang, MD.
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Posterior elbow splinting. Testing of neurovascular function and capillary refill. Video courtesy of Kenneth R Chuang, MD.
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Posterior elbow splinting. Completed splint. Image courtesy of Kenneth R Chuang, MD.
