Forearm volar splint

Background

• May add a dorsal splint for increased stability (‘sandwich splint’)
• Not used for distal radius or ulnar fracture because this splint allows for supination and pronation

Indications

• Soft tissue injuries of the hand and/or wrist
  • For example, sprain, carpal tunnel night splints, etc.
• Most carpal fractures
• 2nd-5th metacarpal fracture

Procedure

Splint Application General Procedure

• Assess pre-procedure neurovascular status (i.e., distal pulse, motor, and sensation)
• Measure and prepare the splinting material
  • May use contralateral extremity if easier
  • Most splints use a width slightly greater than the diameter of the limb
• Apply stockinette (if applicable)
  • Extend 2" beyond estimated the splinting material length
• Apply padding (if applicable)
  • Use 2–3 layers over the area to be splinted / between digits (when applicable)
  • Add an extra 2–3 layers over bony prominences
• Apply splinting material
  • Lightly moisten the splinting material.
  • Place as appropriate to specific splint type
  • Once finished, if applicable fold the ends of stockinette back over the splinting material if there is excess
• Apply elastic bandaging (e.g., ace wrap)
• While still wet
  • May further mold the splint to the desired shape
  • Maintain position until splint material has hardened
• Re-check and document repeat neurovascular status

Splint-Specific Details

• Apply padding and splint material as shown in figure
• Splint course:
  • From dorsal or volar mid-forearm
  • Along volar forearm
  • To the distal palmar crease (i.e., metacarpal heads)
• Key anatomic positions
  • Forearm in neutral position with thumb up
  • Wrist in slight extension (10–20º)
  • Hand is in "holding a can" position

See Also

• Splinting