Sugar tong splint

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Background

  • Prevents pronation/supination, flexion/extension at the wrist, and immobilizes elbow

Indications

Procedure

Sugar tong splint.

Splint Application General Procedure

  • Assess pre-procedure neurovascular status (i.e., distal pulse, motor, and sensation) [2]
  • 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:[2]
    • From proximal palmar crease
    • Around elbow
    • To dorsum of MCP joints
    • Watch for bunching of material around elbow, protect bony prominence such as elbow, ulnar styloid [3]
  • Reassess distal pulse, motor, and sensation
  • Key anatomic positions
    • Elbow at 90°
    • Neutral forearm with thumb pointed superiorly
    • Wrist in slight extension (approximately 10-20°) and slight ulnar deviation

See Also

References

  1. 1.0 1.1 German C. Hand and wrist emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.
  2. 2.0 2.1 Splints and Casts: Indications and Methods. http://www.aafp.org/afp/2009/0901/p491.html Accessed April 5, 2017
  3. Principles of Casting and Splinting http://www.aafp.org/afp/2009/0101/p16.html Accessed April 5, 2017