A splint is a temporary medical device used to stabilize a fracture or severe sprain before definitive treatment can be applied. Splints are preferred over a full cast in the immediate aftermath of an injury because their non-circumferential design allows for natural swelling of the limb. This flexibility helps prevent serious complications like compartment syndrome. The sugar tong splint is a specific type of splinting technique applied primarily to the arm to stabilize injuries of the forearm and wrist.
The name “sugar tong” comes from its distinctive U-shape, which resembles the metal tongs once used to serve sugar cubes. This design involves a single strip of rigid material, usually plaster or fiberglass, that starts on one side of the limb, wraps around a joint, and continues up the opposite side.
Defining Splint Length in Orthopedics
The classification of an orthopedic splint as “long” or “short” is based on the number of major joints it crosses and immobilizes. A splint is considered “short” if it immobilizes only one major joint, such as a wrist splint that stabilizes the wrist joint while leaving the elbow free to move.
Conversely, a splint is classified as “long” when it is designed to immobilize two major joints, typically the joint immediately above and the joint immediately below the injury site. This dual-joint immobilization is necessary to gain full control over the fractured bones. The sugar tong splint is definitively classified as a long splint because it is specifically applied to cross and immobilize both the wrist and the elbow joints.
The Sugar Tong Splint: Application and Classification
The application of the sugar tong splint creates a U-shaped trough that runs down one side of the limb, around the elbow, and up the other side. For a forearm injury, the splint material typically starts near the palm, extends along the forearm, wraps around the back of the elbow flexed at 90 degrees, and continues along the opposite side of the forearm toward the back of the hand. This continuous path, spanning the hand, wrist, and elbow, inherently immobilizes both the wrist and elbow joints.
The primary function of this U-shaped configuration is to eliminate pronation and supination, which are the rotational movements of the forearm. Unlike a simple posterior long arm splint, the sugar tong’s dual-sided coverage is uniquely suited to prevent the forearm from twisting. This rotational control is the reason it is the preferred choice for unstable forearm fractures.
Injuries Treated by Sugar Tong Splints
The sugar tong splint is the treatment of choice for unstable injuries of the forearm and wrist that require stabilization against rotation. Its ability to immobilize the wrist and elbow simultaneously makes it effective for fractures involving the radius and ulna. These include fractures of the shafts of both bones, often referred to as “both-bone” forearm fractures.
It is also commonly used for complex wrist fractures, such as displaced distal radius fractures like Colles’ or Smith’s fractures, where rotational forces can easily displace the broken bone segments. Furthermore, it provides initial support for complex fracture-dislocation patterns like Monteggia or Galeazzi fractures, which involve a fracture of one forearm bone and a dislocation of a nearby joint.
Variations in Application: Forearm Versus Humeral
While the most common application is to the forearm, the sugar tong technique is versatile and can be adapted to other areas of the arm. The standard single sugar tong splint, used for forearm and wrist injuries, immobilizes the wrist and elbow. However, a different variation is used for injuries higher up the arm.
The humeral sugar tong splint is designed for fractures of the mid-shaft of the humerus, the long bone of the upper arm. This variation applies the same U-shaped principle but spans a different set of joints. In this case, the splint extends from the shoulder, wraps around the elbow, and continues back up to the shoulder area. This configuration effectively immobilizes the elbow and the shoulder joints, making it another example of a dual-joint, or “long,” splint.