This is a long arm splint, so I'm actually going to use two different sizes of stockinette. Cut a slit in the stockinette for the thumb to pass through. Note that you may also use two different sizes of stockinette, using a larger stockinette for the upper arm. Place the stockinette from the fingertips to the shoulder. Be sure to smooth out all wrinkles in the stockinette. Start wrapping the cast padding at the wrist, and bring the padding down through the web space between the thumb and index finger. Make three turns for a bumper on the hand. Wrap the padding up the arm to the shoulder using a 50-50 coverage level. Make three turns at the ends of the cast for a bumper. Wrap back down towards the hand to ensure adequate padding. Place additional padding over the elbow and pad bony prominences. On a long arm splint you can use a 4x38 or a 3x38 depending on the size of the arm. What I'm using is a 4x38. Place the fiberglass splint on the lateral side of the arm from the palmar crease or base of the 5th finger within 1 inch of the padding. Wrap the splint on with gauze or padding. Bring the splint up behind the arm so it comes up on the back side. You can either cut your splint off at the top of the padding or, to add additional strength, you can fold the splint over the padding back down toward the front of the elbow and wrap with another layer of padding or gauze. It just gives you a little bit more strength to hold it and keep it from letting go. Snip the splint at the bend of the elbow to fold fiberglass as you wrap. One underneath and one out here. We're going to wrap those in. And then your splint comes down to join with your bottom splint. Bring your stockinette down. Cut two slits opposite of each other in the padding at the hand. Fold back the cast padding. And fold back the stockinette. And then we finish up with our elastic wrap. Note that if you did not do the reinforcement portion of this splint, you will need to create using a 2-inch cling. Wrap around the bicep and bring the cling down to mid-forearm to create a bridge between the bicep and forearm. Then wrap up the piece of cling connecting the bicep and forearm. You can then go back and roll the bridge into the splint so that the bridge does not get caught on the patient's clothes. Finish by wrapping the splint with a roll of gauze and tape or colored adhesive self-adhering wrap. And that is a posterior long arm splint with and without a Boyd bridge.

long arm splint

stockinette

cast padding

fiberglass splint

gauze