AAOE Casting, Splinting and Soft Goods Program-Splinting

Video Transcription

So we're going to do a dorsal blocking splint. Make a slit in the stockinette for the thumb. Slide the stockinette over the fingers and thumb and down the arm.  Ensure that the stockinette extends 2-3 inches beyond the fingertips. You may also use a second 1-inch stockinette to place over the thumb.  Wrap cast padding starting at the wrist and continue to wrap through the web space of the index finger and thumb, up the hand to the very tip of the fingers.  Make three turns at the very distal end. The placement of the padding may vary by physician's order.  Work your way back down around the hand, through the web space of the index finger and thumb, around the wrist, and down the arm, using 50-50 coverage.  Wrap the padding around three turns for bumpers at the proximal end of the padding.  Come back up the arm and end around the wrist, always using 50-50 coverage.  Patch any bony prominences now, if needed.  Cut the splint, leaving rounded edges to the approximate length.  The splint should fall approximately one inch from the edge of padding.  And you want to round the ends of your splint.  Wet the fiberglass splint or plaster and wring out as much water as possible.  Place the splint material on the dorsal aspect of the hand and arm,  with the distal end at the tips of the fingers and the proximal end just before the bumper and cuff.  Wrap the splint using either gauze or padding from the fingertips down around the hand,  through the web space of the thumb and down the arm.  Be sure to keep the wrist back to help prevent wrinkles.  Mold the splint by holding the fingers and wrist in the position that was ordered by the physician, generally Intrinsic Plus, which has the wrist at 10° to 30° of hyperextension,  the MCP joints in 70° to 90° of flexion, and the IPs in full extension. Make two small cuts at each end of the padding. Fold the stockinette at each end.  Use an elastic bandage, gauze wrap, and or colored adhesive self-adhering wrap to wrap and hold the stockinette in place.  And that is a dorsal blocking splint.

Video Summary

The video demonstrates how to apply a dorsal blocking splint. The process involves making a slit in the stockinette for the thumb, sliding the stockinette over the fingers and thumb, and down the arm. Cast padding is wrapped starting at the wrist, through the web space of the index finger and thumb, and up the hand to the fingertips. The padding is then wrapped back down around the hand, wrist, and arm using 50-50 coverage. Bony prominences are patched if necessary. The splint material is wetted, placed on the dorsal aspect of the hand and arm, and wrapped using gauze or padding. The splint is molded to the desired position and secured with an elastic bandage or self-adhering wrap.

Keywords

dorsal blocking splint

applying splint

cast padding

splint material

molding splint