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AAOE Casting, Splinting and Soft Goods Program
Splinting - Coaptation Splint
Splinting - Coaptation Splint
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Video Transcription
It's usually used on a patient with a humeral fracture, and they are usually in a lot of pain, so you have to work around your patient a lot. The best thing to do is get them to lean out to the side. If you are using a stockinette, cut a slit a quarter of the way down one side of the stockinette and slide the stockinette up over the arm to above the shoulder. And then I also take right at the end of that cut and make a little bit of a diagonal cut. Slide the stockinette over the arm with the cut side resting up over the shoulder. So we're going to slide over the hand, bring the stockinette up, and so you're just going to lay the stockinette across the shoulder. Keep the elbow back at 90 degrees. Begin to wrap the cast padding just before the elbow, approximately 2 to 3 inches distal of the antecubital space. Take 3 to 4 turns for a bumper. Wrap around the elbow in a figure 8 if necessary. And continue wrapping in a 50-50 pattern up the arm as high on the shoulder as allowed. Continue to wrap down the arm distally to ensure adequate padding. Be sure to listen to your patient. Only they know how it feels. Be sure you have good coverage over your elbow. Using cast padding or felt pad, patch the most proximal point on the top of the shoulder and at the ending point in the axilla. You just put this up way over the shoulder. It just helps pad the top of that splint. Take the measured strip of fiberglass splint or plaster and wet it. Wring out most of the water. Apply the splint, starting with one end in the axilla, and begin wrapping with cast padding or gauze to hold the splint in place. Keeping the elbow at 90 degrees, make a U-shape with the splint around the elbow and up the lateral side of the upper arm, extending up over the shoulder. Continue to wrap the splint with cast padding or gauze to hold it in place. Before wrapping the elbow, cut away excess splint at the back of the elbow before wrapping. And when you're working on a patient, you would just let them rest their arm down right now and really let that splint dry before you move on. Cut the splint to the appropriate length at the top of the shoulder. Hold the top of the splint at the shoulder until it begins to harden. Cut away padding at the elbow to allow the elbow to bend. Make two slits on either side of the axilla to fold the cast padding down over the splint. And the little diagonal piece that you cut in the sock net, you can get a hold of that and that helps anchor that underneath. Wrap to hold the folded cast padding in place. Okay, now when you get that anchored, this is firmed up, you're going to pull your stockinette where you fold that. Fold the stockinette back over the padding at both ends. And then you have to tuck these edges. Your stockinette, just bring them in. Wrap the splint with the elastic bandages, gauze wrap, or colored adhesive self-adhering wrap to hold in place. Fold your edge back down here. Make sure you have good padding underneath. If you don't, you need to add some right here because that takes a lot of pressure in this splint. Then you take your elastic wrap or co-band or whatever it is you're going to use and wrap it all in. Come on, lift up one time. And that is your coaptation splint.
Video Summary
The video demonstrates how to apply a coaptation splint for a patient with a humeral fracture. The process involves using a stockinette to cover the arm, wrapping the arm with cast padding, applying a fiberglass splint or plaster, cutting excess splint material, folding and securing the padding, and finally wrapping the splint with elastic bandages to hold it in place. The goal is to immobilize the arm and provide support for the fractured bone. It is important to listen to the patient's feedback during the process and ensure adequate padding for comfort and pressure distribution.
Keywords
coaptation splint
humeral fracture
stockinette
cast padding
fiberglass splint
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