A splint is a temporary, non-circumferential medical device designed to immobilize a limb or joint, providing support while allowing for potential swelling. It stabilizes an injured area, such as a fracture or severe sprain, by restricting movement that could cause further damage. Wearing a splint supports the natural healing process, reduces pain caused by motion, and protects the injured structure until definitive treatment can occur.
Proper Application and Securing the Splint
The effectiveness of a splint begins with correct application, stabilizing the injury in a resting anatomical position. This intentional positioning, known as the position of function, helps prevent muscle shortening and joint stiffness during immobilization. For example, a wrist splint should hold the hand in slight extension, and an ankle splint often positions the foot at a 90-degree angle to the leg.
Before securing the splint, ensure that underlying padding material is smooth and adequately covers bony prominences like the elbow, wrist, or heel, which are susceptible to pressure sores. The splint material should align precisely with the injury site to provide maximum support without impinging on unaffected joints.
Once the splint is positioned, securing straps or elastic bandages must be applied firmly but comfortably. The goal is to hold the splint securely against the limb to prevent slippage without restricting circulation. A general rule is that you should be able to slide one finger easily between the splint and the skin.
Immediately after securing the device, check the extremity’s circulation by observing the fingers or toes distal to the splint for color, warmth, and sensation. They should remain pink, warm, and the patient should have full feeling and the ability to wiggle them freely. Any change to a pale or bluish color, coolness, or the onset of numbness indicates excessive pressure and requires immediate adjustment of the straps.
Daily Management and Skin Care
Maintaining the integrity of the splint and the health of the skin underneath requires a consistent daily routine. A fundamental rule is to keep the splint completely dry, as moisture can weaken materials like plaster and lead to skin maceration or irritation beneath the padding. When bathing, a waterproof cover, such as a plastic bag sealed with tape, should be used to protect the splint from any water exposure.
If the splint is removable, a daily skin check is recommended, looking for areas of redness, chafing, or blistering, especially along the edges or over bony areas. If the splint is non-removable, focus on inspecting the skin immediately surrounding the perimeter for signs of pressure or friction. Any persistent discoloration or skin breakdown needs to be reported to a healthcare provider.
Managing the inevitable itching that occurs beneath the splint must be done without inserting any objects inside the device. Using a foreign object can cause a scratch or tear in the skin, potentially leading to a serious infection or pressure sore. Instead, try gently blowing cool air from a hairdryer on the “cool” setting into the opening of the splint to relieve the sensation.
The outside of the splint can be spot cleaned if necessary, typically with a cloth lightly dampened with mild soap and water, avoiding saturation of the padding. Regularly inspect the straps and fasteners for wear, as compromised strapping can allow the splint to shift, reducing its ability to properly immobilize the injured area.
Navigating Activities and Wear Schedule
Adhering to the prescribed wear schedule is directly tied to the success of the healing process. While some injuries require continuous immobilization, others may permit removal for specific activities, like hygiene or gentle range-of-motion exercises, as directed by a clinician. A removable splint should be worn exactly as instructed, as removing it prematurely or too often risks re-injury.
Daily activities must be modified to prevent undue stress on the injured limb; this typically includes a restriction on lifting objects heavier than a few pounds, often specified around two kilograms. For injuries to the lower extremity, weight-bearing restrictions must be strictly followed, using crutches or other assistance devices if required.
To reduce swelling, especially in the first few days, the injured limb should be elevated above the level of the heart as frequently as possible. This is achieved by propping the arm or leg on pillows while sitting or lying down, using gravity to encourage fluid drainage. Maintaining comfortable elevation during sleep can help reduce nighttime discomfort and swelling.
Recognizing Complications and When to Seek Help
Certain physical sensations or changes can signal a complication, requiring immediate attention to prevent long-term damage. Persistent or increasing pain that does not improve with prescribed medication, rest, or elevation is a warning sign. This discomfort may indicate the splint is too tight due to underlying swelling or is improperly placed, putting pressure on a nerve.
Any new onset of numbness, tingling, or a “pins and needles” sensation, medically termed paresthesia, suggests pressure on the nerves. Similarly, a noticeable change in the color of the exposed fingers or toes to a pale, white, or bluish hue, accompanied by coolness to the touch, indicates a compromise of blood flow. These neurovascular symptoms necessitate prompt medical evaluation.
Other signs of potential complications include severe swelling that extends beyond the ends of the splint or the development of a foul odor emanating from the padding. A foul smell may suggest an underlying infection or significant skin breakdown beneath the device, which requires a professional assessment. A fever without any other clear cause can also be a systemic sign of infection.
If these concerning symptoms arise, first try elevating the limb and slightly loosening any adjustable straps, if permitted by the healthcare provider. If the symptoms do not resolve quickly after these minor adjustments, or if you suspect an infection, contact your doctor or seek emergency medical attention immediately.