PL AYI NG I N PL AST E R T HE BASI CS OF SPL I NT I - - PowerPoint PPT Presentation

PL AYI NG I N PL AST E R – T HE BASI CS OF SPL I NT I NG

K a ri M. K

• mlo fske , F

NP-C & Jo hn Wo rking e r, F NP-C

OBJE CT I VE S

 T

• de mo nstra te a n inc re a se d a b ility in

ide ntifying va rio us type s o f fra c ture s

 Unde rsta nd the va rio us splinting o ptio ns;

c ho o sing the a ppro pria te splint fo r a g ive n fra c ture

 E

va lua te a nd unde rsta nd splint a pplic a tio n

 Disc uss multiple me dic a tio ns use d in

tre a tme nt o f o rtho pe dic injurie s

WHY SPL I NT

 T

• sta b ilize a fra c ture

 Assist in ma king a pa tie nt mo re

c o mfo rta b le

 Pro mo te va sc ula riza tio n  Pre ve nt wo und o r tissue c o mpro mise  T

ra nspo rta tio n

F ra c ture s

 Ope n o r Clo se d fra c ture

 Ope n – A fra c ture tha t b re a ks thro ug h the

skin T his fra c ture sho uld ha ve imme dia te re fe rra l to o rtho pe dic s (ma y ne e d to g o to the o pe ra ting ro o m)

 Clo se d – A fra c ture tha t is c o nta ine d in the

skin L

• o k fo r va sc ula r c o mpro mise a nd skin

te nting

Displa c e d o r No n-Displa c e d?

 DI

SPL ACE D

 NON-DI

SPL ACE D

SPL I NT T YPE S

 Ulna r Gutte r  T

humb Spic a

 Sug a r T

• ng

 F

ing e r Splint

 Do rsa l F

• re a rm

 Sho rt L

e g Splint

UL NAR GUT T E R

 Ulna r Gutte r Splint - is use d to suppo rt,

sta b ilize a nd immo b ilize dislo c a tio ns a nd fra c ture s o f the ha nds, fing e rs o r wrists.

T HUMB SPI CA

 T

humb Spic a -- immo b ilize the thumb a nd/ o r wrist while a llo wing o the r dig its fre e do m to mo ve . I t pro vide s suppo rt fo r thumb injurie s (lig a me nt insta b ility, spra in

• r musc le stra in), g a me ke e pe r's thumb ,
• ste o a rthritis, de Que rva in's syndro me ,

sc aphoid fr ac tur e, thumb spra ins.

SUGAR T ONG

 SUGAR T

ONG -- splinting fra c ture s o f the ra dius, ulna , o r wrist. I t pre ve nts fle xio n a nd e xte nsio n a t the wrist, limits fle xio n a nd e xte nsio n a t the e lb o w, a nd pre ve nts supina tio n a nd pro na tio n.

F I NGE R SPL I NT

 F

I NGE R SPL I NT

• - c a n b e use d to tre a t a

va rie ty o f c o nditio ns fro m ma lle t fing e r a nd a rthritis to swa n ne c k de fo rmity.

DORSAL F ORE ARM

 DORSAL

F ORE ARM -- So ft tissue injurie s o r fra c ture s o f the ha nd a nd wrist Ca rpa l b o ne fra c ture s, 2nd – 5th MC he a d fra c ture s

 Splint -Sta rts in the pa lm a t the MC he a ds,

do wn the vo la r a spe c t o f fo re a rm to dista l fo re a rm

Sho rt L e g Splint

 Se ve re a nkle spra ins  F

ra c ture s o f dista l fib ula a nd tib ia

 Re duc e d a nkle dislo c a tio ns

OT HE R F RACT URE S:

 CL

AVI CL E

 HUME

RUS

 F

E MUR

 HI

P

 E

L BOW

DI SCUSSI ON

Co nc e rns

 Swe lling  Circ ula tio n

Alig nme nt

 Po sitio ning  Co mfo rt - Suppo rt

PAI

N ME DI CAT I ON

Swe lling , fra c ture b liste rs – c a use pro b le ms….

Pha rma c o lo g ic a l o ptio ns

 Ac e ta mino phe n  AVOI

D NSAI DS in a c ute F RACT URE S

 Musc le re la xa nts – fle xe ril, ske la xin  Na rc o tic s – No rc o , pe rc o c e t, o xyc o do ne ,

dila udid, mo rphine

 I

mme dia te re le a se ve rsus e xte nde d re le a se

No n-pha rma c o lo g ic a l o ptio ns

 He a t  I

c e

 E

le va tio n

 Ma ssa g e  Ac upunc ture  Chiro pra c to r

SPL I NT I NG SUPPL I E S

Sto c kine tte Pla ste r o f Pa ris Strips o r ro lls (2-, 3-, 4- o r 6-inc h widths) Pre fa b ric a te d Splint Ro lls Pla ste r F ib e rg la ss with po lypro pyle ne pa dding Pa dding (We b ril) Ac e Wra p Buc ke t/ re c e pta c le o f wa rm wa te r T ra uma she a rs

PROCE DURE Sto c kine tte is a pplie d (o ptio na l) We b ril is a pplie d T he we t pla ste r is po sitio ne d We b ril o n o utside E la stic b a nda g e is a pplie d T he pla ste r is mo lde d

L E T ’ S PL AY WI T H PL AST E R

My Da ug hte r Britta ny 20 ye a rs o ld

My so n Ja c kso n 17 ye a rs o ld

So I ha ve to do this…

RE F E RE NCE S

 Sa rwa rk, Jo hn, F

. (2010). E sse ntia ls o f Musc ulo ske le ta l Ca re 4. Ro se mo nt, I L : Ame ric a n Ac a de my o f Ortho pa e dic Surg e o ns.

 Sto lle r, Da vid, W. (2008). Sto lle r's Atla s o f

Ortho pa e dic s a nd Spo rts Me dic ine . Ba ltimo re , MD: L ippinc o tt Willia ms & Wilkins, a Wo lte rs K luwe r b usine ss. Bic kle y, L ynn, S. (2007).

 Ba te s' Guide to Physic a l E

xa mina tio n a nd Histo ry T a king , 9th e d. Phila de lphia , PA: L ippinc o tt Willia ms & Wilkins