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Performance SplintingTM
Splinting
Pocket
Guide
Tel: 877.631.3077 • Fax 336.631.3060
www.CNFMedical.com
Positions of Function
These functional positions are indicated for many injuries and are
a general guideline only. It is important to position appropriate to
the injury, individual patient needs, and physician preference.
1. VOLAR SPLINT – Position the wrist at neutral to 20 degrees
extension and allow free motion of all fingers and thumb.
2. VOLAR DORSAL – Position the wrist at 20 degrees extension,
allowing free motion of all fingers and thumb.
3. THUMB SPICA – Place thumb in a functional position with the
wrist in approximately 30 degrees extension and thumb and index
finger in opposition.
4. OPEN THUMB – Flex Metacarpals in 45 - 70 degree angle and
wrist in 20 degrees extention.
5. BOXER/ULNAR GUTTER (4th-5th Metacarpal) – Position the
wrist at 20 degrees extension, the MCP joint at 45-70 degrees flexion, depending on the injury.
6. REVERSE SUGAR TONG – Position the wrist at neutral and
the elbow flexed at 90 degrees.
7. ELBOW SPLINT – Position the wrist at neutral and the elbow at
90 degrees.
8. KNEE IMMOBILIZER – The physician will want to splint
the knee fully extended if possible, but for proper gait and crutch
walking a 15 degree flexion at the knee may be necessary.
9. POSTERIOR ANKLE – Position with the ankle at 90 degrees
(neutral), unless otherwise instructed.
10. ANKLE STIRRUP – The foot should be flexed at a 90 degree
angle, unless otherwise directed.
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Preparation Guidelines
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Choose splint material width (2” to 6”).
Cut length as measured.
Push splint roll back inside foil, then reseal foil end with clip.
Stretch padding over both ends to cover exposed fiberglass edges.
Use minimal amount of cool water to activate.
Roll in towel twice to remove excess water.
Apply padding to patient, then secure splint with elastic bandage.
Mold splint to extremity with palm.
Monitor patient according to standard procedures.
Tips for Better Splinting
1. Pre and post splint checks are imperative.
Use this formula: F - A - C - T - S to check for
Function
Arterial Pulse
Capillary Refill
Temperature - skin
Sensation
2. Always use cool, clean water. Do not over-saturate splint. A minimal amount of water is required to start the setup process.
3. Protect or pad edges of splint.
4. Smooth splint with palm after placing on patient.
5. Roll elastic bandage on the extremity without
tension. Too much tension could lead to
circulation issues and other complications.
6. Leave fingertips exposed to check for circulation.
7. Patient should remain still until heat subsides from the splint to
allow for proper setup.
8.
Patient discharge instructions should include:
- Review F-A-C-T-S with patient.
- Review R-I-C-E Instructions:
Rest / Ice /Compression / Elevation
- Patient should not remove splint unless approved by physician.
- Patient should keep splint dry.
Volar Splint
Use 3” or 4”
Measure from the base of
fingers to 2” from the
antecubital. Cut and
prepare splint.
Fold edge 1” to form pad and
position splint at angle of
palmer crease.
Apply splint with elastic wrap. Mold
with palm and position as prescribed.
Indications: Wrist Sprains, Soft Tissue Injuries,
Lacerations, Night Splints
Volar Splint
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Volar Dorsal
Use 3” or 4”
Measure starting 1” above
the palmer crease to 2” from
the antecubital. Double measurement. Cut and prepare
splint.
Cut splint at middle from
closed edge to taped edge
leaving 1/2” hinge on taped
edge. Stretch padding over
edges.
Place hinge on webspace
allowing splint to cover volar
and dorsal sides.
Secure with elastic wrap starting at
the wrist, then through web space
and around back of the hand,
working distal to proximal to
finish. Mold with palm and
position as prescribed.
Indications: Forearm fracture, severe sprains
Volar Dorsal
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Thumb Spica
Use 3” or 4”
Measure starting at tip of
thumb to 2” from the antecubital. Cut and prepare splint.
Apply splint starting at
thumb, smoothing over the
dorsal aspect of the hand and
forearm.
Secure splint with elastic wrap at wrist, wrap around
thumb and then wrist twice in a figure-8. Finish
wrapping, working distal to proximal. Mold with palm
and position as prescribed.
Indications: Navicular Injuries, Scaphoid Fractures,
Dislocations, UCL Sprains
Thumb Spica
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Open Thumb
Use 4” or 5”
Use 6” for the entire hand
Measure from the tip of
3rd finger to 2” from the
antecubital.
Open padding at taped edge.
Fold fiberglass in 1/2, cut half
moon for thumb hole. Replace
padding, cut slit in padding
aligning with hole in fiberglass.
Place thumb through hole.
Fold splint over 2nd & 3rd
metacarpals.
Secure splint with elastic
wrap. Mold with palm and
position as prescribed.
Indications: 2nd & 3rd Metacarpal Fractures,
Tendon Repairs, Crushing Injuries
Open Thumb
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Boxer/Ulnar Gutter
Use 4” or 5”
Measure from the tip of the
5th finger to 2” from the
antecubital. Cut and prepare
splint.
Place padding between 4th
and 5th fingers.
Apply splint as a gutter to the
ulnar side of the hand.
Secure with elastic wrap.
Mold with palm and position
as prescribed.
Indications: 4th & 5th Metacarpal Fractures
Boxer/Ulner Gutter
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Reverse Sugar Tong
Use 3” or 4”
Measure starting from the
fingertips, down under the
elbow, up to fingertips.
Cut splint at middle from
closed edge to taped edge,
leaving 1/2” hinge on taped
side. Stretch padding over
edges.
Place hinge at webspace,
draping splint over volar
and dorsal sides.
Secure splint with elastic wrap.
Tuck one side of splint under
elbow, overlapping other side.
Finish wrapping in figure-8
pattern to lock in position
Indications: Colles’ Fracture, Forearm Fracture
Reverse Sugar Tong
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Elbow Splint
Use 4” or 5”
Measure from the base of the
5th metacarpal and 3” away
from the axilla.
Apply splint, overlapping
corners of splint at the elbow.
Apply splint with elastic wrap.
Mold with palm and position as prescribed.
Indications: Elbow Sprains, Supracondylar Fractures
Elbow Splint
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Knee Immobilizer
Use 4” or 5”
Use 6” for large adult
Measure 8-10 inches above
and below patella.
Double measurement.
Cut splint at middle from
closed edge to taped edge,
leaving 1/2” hinge on taped
side. Stretch padding over
edges.
Apply splint sections on
either side of patella with
hinge located as shown.
Secure splint with elastic
wrap, working distal to
proximal. Mold with palm
and position as prescribed.
Indications: Knee injuries, Post-op Knee Surgery
Knee Immobilizer
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Posterior Ankle
Use 4” or 5”
Measure starting 2” beyond
the toes to 2” below the
popliteal.
Fold splint under at toes for
comfort, place splint beyond
and begin wrapping at toes
and up foot, excluding ankle,
wrap once at achilles.
Fold corners of splint
below ankle.
Continue wrapping elastic
bandage around heel and up
leg to 2” below the popliteal.
Mold with palm and position
as prescribed.
Indications: Ankle Sprains, Achilles Tendon Tears,
Metatarsal/Tib/Fib Fractures
Posterior Ankle
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Ankle Stirrup
Use 3”
Measure starting approximately 2” below the patella
from lateral side, under heel,
up to medial side of patella.
Open padding at taped edge
in heel area of splint, cut
out 3” of fiberglass for heel
comfort, close padding at
taped edge.
Apply splint in stirrup style, centering heel on
“padding-only” area. Secure at ankle with elastic
wrap using several figure-8’s around plantar aspect
and ankle, working distal to proximal. Mold with
palm and position as prescribed.
Indications: Ankle Sprain, Hairline Fracture
Ankle Stirrup
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Splinting
Pocket
Guide
Tel: 877.631.3077 • Fax 336.631.3060
www.CNFMedical.com