Splinting

Splinting



Basic Information image



Synonym(s)




Temporary external coaptation



Overview and Goal(s)


A splint is an external rigid support applied to provide temporary external fixation of a limb.



Indications




• Indications for splinting in adults include temporary support of fractures and adjunct therapy for internal fixation of fractures, tendon lacerations, and wound management.


• Splints are also used in foals as treatment for incomplete ossification of the carpal or tarsal bones to prevent further cartilage damage, or as a definitive therapy for tendon contracture.



Contraindications


Any horse that will not tolerate immobilization without further injuring itself



Equipment, Anesthesia




• A bandage should be applied to the leg prior to splint application.


image The bandage should be thick enough to prevent rubs but not too thick to allow the bones to move beneath the bandage.

image Materials needed for the bandage beneath the splint include cotton combine or roll cotton, brown gauze, Vet-wrap, and elastic tape.

• The splint can be made of PVC pipe (schedule 40 or 80), wood, metal, or cast material.


image Wood is a difficult material to use because small pieces do not provide enough strength while large pieces do not conform to the leg well.

image PVC also does not conform to the leg well but may be bent to improve fit.

image Cast material conforms well to the leg but does not provide as much support as a true cast when placed over a bandage.

image Premade stainless steel splints are very convenient for immobilization of distal limb injuries but alone provide little lateral to medial support.

• Extra cotton and nonelastic tape (duct tape, white tape) should be available to pad the top of splints.



Anticipated Time


A typical splint takes 15 to 20 minutes to apply.



Preparation: Important Checkpoints




• All wounds should be addressed and bandaged prior to applying a splint over them.


• The horse may be sedated to allow splint application, but sedation should be kept light to prevent excessive weight bearing on the injured limb.



Possible Complications and Common Errors to Be Avoided


The splint should be steadied by a second person to prevent rotation when applying the nonelastic tape.



Procedure


Splinting is divided into four anatomical levels based on the type of splint required (Figure 1):


Level 1



• Fractures of distal metacarpus/metatarsus, first and second phalangeal bones, and proximal sesamoid bones


• Luxation of the pastern or fetlock joints


• Flexor tendon laceration at the pastern or the metacarpus/metatarsus


• Goal: Align the dorsal cortices of the bones


• Procedure:


image Apply a light Robert Jones bandage from the carpus, distal.

image Have handler hold leg by radius or tibia to suspend the leg in the air.

image Place a dorsal splint on the forelimb or a plantar splint on the hindlimb from the ground to the proximal edge of the third metacarpal/metatarsal bone.
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Jul 24, 2016 | Posted by in SMALL ANIMAL | Comments Off on Splinting

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