When can a posterior long arm splint not be used?
Certain injuries require immediate evaluation or intervention by a consultant (e.g., an orthopedic surgeon, a hand surgeon, a plastic surgeon, etc.), and splinting alone cannot be the treatment. Such injuries include the following:
- Complicated or multiple fractures
- Open fractures
- Injuries associated with nerves and blood vessels
How is a posterior long arm splint performed?
Splinting is usually tolerated without the use of anesthesia. However, if a significant manipulation of the injury is required during the splinting process, anesthetic techniques may be used.
- These splints are made of plaster, fiberglass, or a low-temperature thermoplastic material with sufficient padding or cotton.
- The elbow is positioned at a 90° bend, and the splint is applied to the back of the arm, covering half the length of the upper arm bone, ending above or below the wrist.
- Elbow bending and straightening are prevented by a posterior long arm splint, and rotation of the forearm is limited but not completely restricted.
- With the patient adequately positioned, a web roll is started at the wrist and extending past the elbow to the upper arm. The number of layers is determined by the amount of expected swelling, but many splints will use two to four layers.
- At the elbow, a web role must be carefully applied to ensure adequate padding of the body part of the elbow. A web roll may be extended till the upper arm bone: humerus.
- A splint may be applied around the elbow and major aspects of the wrist. Care should be taken to allow moments in fingers. A mold is applied with a splint to keep the fractured bone in position.
- An elastic bandage is wrapped over the splint materials to keep the splint in position.