Let's Review Upper extremity Splinting

 Volar Splint

Indications:
-Hand and Wrist injures (NOT distal radius or ulna fractures, can still supinate and pronate)
-Carpal fractures
-Lunate dislocation
-2nd-5th metacarpal head fracture
​
Application:
-Extends along volar forearm from metacarpal heads to just proximal to radial head
-Allow flexion of elbow
-Wrist at 20 degrees of extension
​-Can add dorsal "sandwich" for stability

​Ulnar Gutter Splint

Indications:
-4th and 5th phalanges and metacarpals

Application:
-Extends from 5th DIP to proximal forearm
-Wrist at 20 degrees of extension
-Flex MCPs at 50-70 degrees, PIP and DIPs in slight flexion

​Thumb Spica Splint

Indications:
-Scaphoid and lunate fractures
-1st metacarpal fracture
-Thumb fractures
-De Quervain tenosynovitis

Application:
-Extends from tip of thumb to proximal forearm
-Wrist at 20 degrees of extension
-Thumb slightly flexed

​Long Arm Splint

Indications:
-Proximal forearm and elbow fractures
-Intraarticular fractures of distal humerus and olecranon

Application:
-Elbow at 90 degrees of flexion
-Neutral forearm and wrist

Sugar Tong Splint

Indications:
-Wrist and distal forearm fractures

Application:
-Extends from MCPs on dorsum, around elbow, to volar midpalmar crease
-Elbow at 90 degrees of flexion
-Neutral forearm and wrist
​-Double sugar tong for complex or unstable forearm and elbow fractures

Resources:
Michael T Fitch, MD. Basic Splinting Techniques. New England Journal of Medicine. 2008; 359:e32.
​Wikiem.com
Ortho-teaching.feinberg.northwestern.edu/docs/Splinting.pptx