A volar splint is a temporary orthopedic device used to immobilize the wrist and forearm following an injury or to manage painful inflammatory conditions. This support mechanism is often applied in emergency settings because its design accommodates the natural swelling that occurs in the acute phase of an injury. Unlike a full cast, a splint is non-circumferential, meaning it does not wrap entirely around the limb. This allows healthcare providers to easily remove it for wound checks or to monitor for complications. The device stabilizes the injured area, which minimizes pain and prevents further damage while the body begins the healing process.
Anatomy and Purpose of the Volar Splint
The term “volar” refers specifically to the palm side of the hand and the corresponding surface of the forearm where this splint is positioned. The splint material, typically molded from plaster, padded fiberglass, or preformed plastic, extends along the underside of the forearm. Its length usually runs from the mid-forearm to the distal palmar crease, leaving the fingers and thumb free to move, which is important for monitoring nerve function.
The mechanical function of the volar splint is to hold the wrist in a specific, functional position, often with a slight degree of extension, generally between 10 and 20 degrees. This position, sometimes described as the “holding a can” position, helps to relieve tension on the flexor tendons and ligaments of the wrist. By immobilizing the wrist joint, the splint effectively reduces motion across the injury site, decreasing pain and facilitating tissue repair.
The non-rigid structure is secured with an elastic bandage, which ensures stability without constricting the limb entirely. The splinting material is applied over a layer of stockinette and cotton padding, which protects the skin and bony prominences from direct pressure. The volar splint is a temporary measure, providing support until swelling subsides or until a more definitive treatment, such as a cast or surgery, can be performed.
Common Conditions Requiring Volar Splinting
Volar splinting is frequently used to manage a range of acute bone and soft tissue injuries affecting the wrist and hand. A common indication is the stabilization of distal radius fractures, such as Colles’ or Smith fractures, which involve a break near the end of the forearm bone. It also provides support for certain stable, non-displaced fractures of the carpal bones (wrist bones) and metacarpals (hand bones). However, it is not used for fractures of the thumb or the trapezium.
Beyond fractures, the device is effective for soft tissue trauma, including significant sprains, strains, and injuries to ligaments or tendons in the wrist. It may be applied after a joint dislocation has been corrected to maintain the proper alignment and allow the surrounding structures to settle. The immobilization provided by the splint helps protect the area from further strain during the initial recovery period.
The splint is also a therapeutic option for non-traumatic conditions that cause inflammation and pain in the wrist. These can include flare-ups of acute carpal tunnel syndrome, where the splint helps keep the wrist in a neutral position to alleviate pressure on the median nerve. It is sometimes employed to manage painful joint inflammation seen in conditions like acute gouty arthritis or active rheumatoid arthritis, offering rest and relief to the affected joints.
Practical Care and Monitoring
The splint must be kept completely dry, as moisture can soften the materials, compromise stability, and irritate the underlying skin. This requires avoiding water exposure during bathing and protecting the splint from rain or other liquids.
Patients should avoid inserting any objects into the splint to scratch an itch, as this can damage the skin and introduce bacteria, potentially leading to infection. The skin around the edges of the splint should be checked daily for any signs of redness, sores, or irritation caused by rubbing. Do not attempt to adjust or manipulate the splint or the elastic bandage without consulting a healthcare professional.
Monitoring for signs of neurovascular compromise is necessary, as swelling can increase pressure on the blood vessels and nerves. Seek immediate medical attention if you experience increased pain not relieved by medication or rest, or if you notice any changes in sensation, such as persistent numbness or pins and needles. Other concerning signs include the fingers turning blue or pale, feeling excessively cold, or an inability to move the fingers that are not immobilized by the splint.