Splint

A splint is really a device used for support or immobilization of limbs or from the spine. It can be used:
By the emergency medical services or by volunteer first responders, to immobilize a fractured limb prior to the transportation; it is then a brief immobilization;
By allied health professionals such as occupational therapists, physiotherapists and orthotists, to immobilize an articulation (e.g. the knee) that may be freed while not standing (e.g. while asleep).
By athletic trainers to immobilize a hurt bone or joint to facilitate safer transportation from the injured person.
By er physicians to stabilize fractures or sprains until follow-up appointment by having an Orthopedist.
In most ERs, a fibreglass splinting material, called Orthoglass, is often used for several reasons.
It is clean, unlike most plaster splinting materials
It is available in rolls and can easily be measured and cut based on the patient's dimensions.
It comes pre-padded, which saves time and effort trying to roll out padding.
It dries within 20 minutes, and there aren't any risks for burns involved.
A nasal splint helps control bleeding and supply support in certain cases in which the nose bone is broken.

Purpose of Splinting
Splints serve the following purposes:
• Improve position
Prevent deformity/contracture
Correct deformity/contracture
Provide rest to some joint by relieving stress of maintaining muscle contraction
Maintain skeletal alignment

• Improve function
Position extremity for improved function
Assist weak movement
Replacement for absent movement
Transfer movement in one joint to another (e.g. tenodesis)
Help in muscle re-education and exercise

CLASSIFICATION OF SPLINTS
Static splints don't have any moving parts and hold affected area of the limb immobilized, approximating the position of function.
Dynamic splints have moving parts for example joints, hinges or springs. Elastic tension using outriggers and finger cuffs apply forces to replacement for or counteract the result of absent muscle power.
Positioning splits are made to correct or prevent deformity/contracture.
Functional splints are made to improve function and/or replacement for limited movement.
Functional and positioning splints might be either static or dynamic.
 An opponens splint, which positions the thumb to enhance prehension patterns, is an illustration of a static functional splint.
 A complete hand positioning splint to fix or prevent flexion contractures from the wrist and fingers within an example of a static positioning splint.

USES
Splints are most commonly accustomed to immobilize broken bones or dislocated joints. Whenever a broken bone continues to be properly set, a splint permits complete rest to begin of the fracture and therefore allows natural healing to occur with the bone within the proper position. Splints will also be necessary to immobilize unset fractures whenever a patient is moved after any sort of accident; they prevent motion from the fractured bone, that might cause greater damage.
Inside a pelvic or spinal fracture, the result of splinting is achieved by placing the individual on a stretcher or board. Breaks from the ribs and of face and skull bones tend not to require the use of splints, as these parts are naturally splinted by adjacent bone and tissue.

MAKING AND APPLYING SPLINTS
A splint could be improvised from a variety of materials, but should usually be light, straight, and rigid. It ought to be long enough to extend past the joint above the injury and underneath the fracture site. A board used like a splint should be at least as wide because the injured part. Tightly rolled newspapers or magazines may be used to splint the arm or calf. Ice cream sticks happen to be used as splints for broken fingers.
Splints ought to be padded, at least somewhere. Thick soft padding permits the injured part to swell and reduces interference with circulation. Bandages or strips of cloth or adhesive tape are utilized to hold splints in place. Pulses distal towards the injury should be checked pre and post splinting to determine whether the circulation has been impaired. When the limb becomes cold, pale, or blue, or maybe the affected part becomes too painful, the splint ought to be loosened. Splints should never be tight.

INTERNAL SPLINTS
Internal splints, in addition to pins, wires, along with other devices for the fixation of fractures, are some of the more spectacular advances in orthopedics. They've worked wonders within the setting of hip fractures, particularly in older people. Internal splints are for sale to almost every type of fracture. Stainless, titanium, and Vitallium are the most often used materials. Splints and devices of the type require surgery for insertion, but they are less cumbersome than external splints and enable earlier use of the fractured.

SPLINT DESIGN
After assessment from the patient's function/dysfunction, therapists and orthotists determine the very best splint design. They give consideration to the following:
• The needs and expectations from the patient
• Position
• Areas to be supported
• Distribution of support
 Total contact?
 Small section of support?
• Areas to be exposed
• Exposure of sufficient tactile surface for sensory input
• Points and directions of forces
• Movements which can be restricted by the splint
• Ease of application and elimination of splint
An effective method of determining the above mentioned factors is as follows:
Make use of your own hands to simulate the support, position and forces to become exerted by the splint. While asking the individual to perform desired movements, place extremity in varying positions and supply varying areas of support.
If your particular splint may meet some needs and never others, consider providing several splint for differing purposes, intermittent utilization of splints and construction of the splint with removable parts like a dorsal wrist support having a removable finger extension assist.

TECHNIQUES
Make pattern
Bearing in mind factors listed under Splint Design (Page 4), pick a published pattern or design a custom pattern for that patient.
To adopt a published pattern design:
• Use a felt tip pen to follow the outline from the pattern onto a paper towel, webril (cast padding) or any other pliable material.

• Cut the pattern.

• Fit the pattern around the extremity.

• Adjust the size and shape with the addition of or subtracting from the pattern, using scissors and paper tame, so the pattern conforms towards the area to be taught in splint.

• Make diagonal tuck folds within the pattern to conform to body contours.
To custom web design a pattern:
• Determine area to become covered by the splint.

• Outline this area either visually or utilizing a skin crayon or water soluble felt tip pen.

• Wrap pattern material around limb and draw outline to coincide with line on skin.

• Palpate through pattern material to locate bony landmarks, borders, creases and skin folds, to supply cues to outline area.

• The outline is drawn as the pattern material is lying flush along planes from the extremity. This may require drawing the pattern one section at any given time and then cut out so the next section will fit.

• To make adjustments and inclusions in a pattern, use paper tape. Make darts to alter angles.

• If a pattern is cut bigger than necessary the splint is going to be difficult to mold. The pattern is simpler to mold if cut in keeping with size.

Transfer pattern onto Reveals
• Place your pattern onto a sheet of Reveals considering economical using the remainder of the piece if using a large sheet, or select an appropriately sized rectangular piece in order to save time and avoid waste.

• Trace round the pattern using a china marker or felt tipped pen.

• Cut within the lines to avoid smudges around the splint.

• Another method is to wet your paper pattern, soften an appropriately sized rectangle of Reveals, dip the softened Reveals momentarily in cold water to quench the top then cover using the wet towel pattern. Cut round the pattern and then remove the paper pattern. Return the Reveals pattern to warm water to resoften if cooled an excessive amount of to mold around the patient.