In some cases, your doctor may be able to put a waterproof liner under the cast, which makes the entire cast waterproof. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. The next morning the brash young man notes that his hand is swollen, tender, and painful to move. The splint extends from the dorsal or volar mid-forearm to the distal palmar crease (Figure 7). Check the color and temperature of your skin. Inability to place weight on the leg 3 . Based on a work athttps://litfl.com. Scroll. Don't scratch the skin under the cast by puttingobjects inside the cast. During this time, the external callus gets stronger because it grows thicker and calcifies. Position of Function. Above-elbow backslab for supracondylar fracture. There are several. Lower leg fractures, severe ankle sprains and strains, or fractures. The cast is usually placed two to seven days after the initial injury to allow for resolution of swelling. As your bones remodel, they become a more normal shape and are less fragile. Fractures that are in the proximal pole of the scaphoid, displaced, or not treated soon after injury require surgical . Also used to hold the hip or thigh muscles and tendons in place after Pearls and Pitfalls. (SBQ17SE.29) width: auto; Plaster casts tend to be heavier as well, so they can pose a challenge to small children. write a sentence using the following word: beech; louise verneuil the voice; fda breakthrough device designation list 2021; best clear face masks for speech therapy Stable fractures are generally reevaluated within one to two weeks following cast application to assess cast fit and condition, and to perform radiography to monitor healing and fracture alignment. Google+; alquiler de apartamentos en puerto rico area metro . Also used to hold the hip or thigh muscles and tendons in place after Toe immobilization (comparable to a high-top walking boot or cast shoe); distal metatarsal and phalangeal fractures, particularly of the great toe. Treatment of reduced PIP joint dislocations is similar, but requires a starting angle of 20 degrees. Cast padding is placed between the fingers. We do not endorse non-Cleveland Clinic products or services. ANNE S. BOYD, MD, HOLLY J. BENJAMIN, MD, AND CHAD ASPLUND, MD. Make sure you have the answers to the following questions before you go: You should never hesitate to go see a healthcare provider when theres an emergency. Position of Function. Depending on several factors, it can take weeks to months to heal. 1. Get useful, helpful and relevant health + wellness information. Its important to be patient during the healing time. Upper arm, elbow, or forearm fractures. Healthline Media does not provide medical advice, diagnosis, or treatment. Last medically reviewed on October 29, 2018, The development of fiberglass casting tape in the 1970s led to the water-resistant fiberglass cast thats often used today. Minor finger sprains; stable, nondisplaced, nonangulated shaft fractures of the proximal or middle phalanx.7,8. Minimal angulation or rotation at the fracture site may cause functional problems, such as difficulty with grasp, pinch, or opposition. materials. Comminuted fracture: An impact shatters the bone into many . The knee is positioned in slight flexion. Casting continues with application of stockinette, then circumferential application of two or three layers of cotton padding, and finally circumferential application of plaster or fiber-glass. Quotes From Frankenstein About The Monster Being Rejected; Rutgers Engineering Honors Academy Reddit; News Channel 12 Chattanooga Live; Karikatur Ludwig Xvi Wird Nie Satt; Hays Travel Refund Request; Natalia Grace Barnett Instagram; Pelvis, hip, or thigh fractures. Fractures can also be caused by less traumatic but repeated force. For an average-size adult, upper extremities should be splinted with six to 10 sheets of casting material, whereas lower extremities may require 12 to 15 sheets. Some of these factors include: Regardless of what your doctor recommends, theyll give you a list of instructions to help you take care of your cast or splint and ensure a smooth recovery process. margin-top: 20px; Other health issues. Acute and definitive management of elbow, proximal and mid-shaft forearm, and wrist injuries; acute management of distal radial (nonbuckle) and/or ulnar fractures in children. 4. or bed. Jun 2022 24. emerald lake lodge restaurant menu Facebook; significance of number 21 in hinduism Twitter; is it normal for a cvt transmission to whine? A nerve block is a numbing medicine thats injected straight into the nerves around the area. They typically have a hard, supportive surface made of plaster, plastic, metal, or fiberglass. Pearls and Pitfalls. When you talk with any healthcare provider Heins, K. & Heins, A. __________ 4. The ankle is flexed to 90 degrees (neutral). Diagnosis is made by orthogonal radiographs the hand. Hand and forearm fractures, however, are often reevaluated within the first week. Most are rarely dangerous. As displacement increases, the need for closed reduction . This site uses Akismet to reduce spam. Applied from the chest to the feet. OMT is a hands-on technique used for both diagnosis and treatment by specialized doctors of osteopathic medicine. Advertisement cookies are used to provide visitors with relevant ads and marketing campaigns. Application. Because these help to hold your bone in place as it heals, proper care for the cast is essential for your bone to recover. See a healthcare provider at an emergency department as soon as possible for the best care. This helps to restrict movement and protect the area from further injury. The bone tissues often meld together pretty well. Holding on to safety bars when you get in and out of the bathtub if you dont have great balance. Cleveland Clinic Staff. Long arm casts are used most often in childhood because of the frequency of distal radial, ulnar, and distal humeral fractures.2,10,14. In a previous article in American Family Physician, we discussed the principles and risks of casting and splinting, as well as proper techniques for safe application.6. Common Uses. When there is a concern about a possible tibial shaft fracture, an X-ray will be obtained to determine if the bone is damaged. e^[MK s%, mTuU:}$r k@89f'CDP> An orthopedic cast, or simply cast, is a shell, frequently made from plaster or fiberglass, that encases a limb (or, in some cases, large portions of the body) to stabilize and hold anatomical structuresmost often a broken bone (or bones), in . Also used to hold the leg or foot muscles and tendons in place after surgery to allow healing. Doing yoga or other exercises to improve strength and balance. Inflammation stage: Your body starts to heal right after the fracture. These fractures poses challenges to the treating surgeons as a result of which these fractures are sometime treated unacceptably and leads to poor (PDF) Use of Cobra External Fixator for treatment of Distal Radius Fractures | Upendra Thapa and Niraj Ranjeet - Academia.edu If you wait too long to get treatment then theres a higher likelihood of complications. Also used to hold the forearm or wrist muscles and tendons Epidemiology. Most fractures heal in 6-8 weeks, but this varies tremendously from bone to bone and in each person based on many of the factors discussed above. Common Uses. Your healthcare provider will check for complications in addition to diagnosing the compound fracture itself. A number of factors affect how quickly you may recover from a compound fracture. area include the following: Use a diaper or sanitary napkin around the genital area to prevent leakage or splashing Immobilisation, functional treatment/minimal immobilisation can all be used with similar result. The film stars Vikram in double role alongside Irfan Pathan, Roshan Mathew, Srinidhi Shetty, Mirnalini Ravi, Miya George, Sarjano Khalid, K. S. Ravikumar, Anandaraj, Robo Shankar and Meenakshi Govindarajan play . But opting out of some of these cookies may have an effect on your browsing experience. Application of any immobilizer comes with potential complications, including ischemia, heat injury, pressure sores, skin breakdown, infection, dermatitis, neurologic injury, and compartment syndrome. Applied to the area below the knee to the foot. The typical symptoms of a boxer's fracture are pain or tenderness centered in a specific . Physical therapy after fracture can also help you improve your functional mobility. The usual signs of a tibia fracture include: Severe pain in the extremity 2 . Definitive or alternative treatment of fractures initially managed with a radial gutter splint. If youre taken to the hospital by ambulance after the fracture, the healthcare providers in the ambulance will be able to diagnose it. Bilateral hip spica cast (also known as double hip spica) used for pelvis, hip, or thigh (femur) fractures. The wrist is slightly extended. surgery to allow healing. Psychiatric assessment should be part of the treatment of patients who present to outpatient clinics or emergency department with a Boxers Fracture. Complications that may occur after a compound fracture include: Compound fracture recovery time can be several to many months. By clicking Accept, you consent to the use of ALL the cookies. This callus begins to form shortly after the bone is broken. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation, mask requirements and COVID-19 information, Notice of Intelligent Business Solutions data eventLearn more. Keep the genital area as clean and dry as possible to prevent skin irritation. Physical therapy after a fracture often focuses on overcoming the negative effects of being immobilized by a cast or sling. In case of sale of your personal information, you may opt out by using the link. Yes, there are consequences if the immobilization lasts too long, including: Be sure to clarify the length of immobilization with your healthcare provider. Several layers of padding that are slightly wider and longer than the splint are applied directly to the smoothed, wet splint. Application. The splint covers the radial aspect of the forearm, from the proximal one third of the forearm to just distal to the interphalangeal joint of the thumb, encircling the thumb (Figure 2). Shoulder dislocations or after surgery on the shoulder area. Lower leg fractures, severe ankle sprains andstrains, or fractures. The wet splint is then placed over the padding and molded to the contours of the extremity, and the stockinette and padding are folded back to create a smooth edge (Figure 1). This tutorial provides step-by-step instructions for casting a Boxer's Fracture using 3M casting products. Definitive or alternative treatment of injuries commonly treated with ulnar gutter splint.8. Next, theyll wrap your injury in bandages that are wet with plaster or fiberglass strips. Physicians should start by placing a single sugar-tong splint, as described above (Figure 8). Once an X-ray shows the fracture is healed, the cast can be removed. Support us The Royal Children's Hospital Melbourne. While the outer layer is waterproof, the soft padding underneath is not. Also used to The lower extremity is wrapped with cotton batting and reinforced with a stirrup splint, providing compression and immobilization while allowing for considerable swelling.16. After your compound fracture heals it will still be seen on X-rays, but you may not be able to tell just by looking at the area. This can assess for anger management issues or antisocial traits that need addressing. DETAILS. Content is updated monthly with systematic literature reviews and conferences. If patients not admitted for operative repair, they should have follow up arranged at the orthopaedic or hand surgeons outpatient clinic. This sequel show includes many references to the film trilogy, through memorable quotes, original cast members, as well as a hefty dose of flashback scenes taken directly from the movies. Applied from the upper thighs to the feet. The outside, or hard part of the cast, is made from two different kinds of casting #mergeRow-gdpr fieldset label { Application. Adagio Overview; Examples (videos) Patient education: Cast and splint care (Beyond the Basics) Acute compartment syndrome of the extremities; Ankle fractures in adults; Fractures can also be caused by less traumatic but repeated force. This can be a frustrating period in your life. The types of complete fractures you can get include: Single fracture is where the bone is broken in one place. healthcare provider may give you different numbers. Thanks in advance. The cast must be molded to the medial longitudinal arch with the ankle at 90 degrees to allow for successful ambulation. Pearls and Pitfalls. Once the swelling subsides, your doctor can get a better look at the injury and decide if a more supportive cast is needed. Position of Function. EBAY. Out of these cookies, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. Fiberglass casts dry within a few hours. endstream endobj 429 0 obj <>>>/Filter/Standard/Length 128/O(v12W|,U!>)/P -1340/R 4/StmF/StdCF/StrF/StdCF/U(8VEr#\n )/V 4>> endobj 430 0 obj <>/Metadata 43 0 R/PageLabels 423 0 R/Pages 426 0 R/StructTreeRoot 62 0 R/Type/Catalog/ViewerPreferences<>>> endobj 431 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/StructParents 0/TrimBox[0.0 0.0 396.0 612.0]/Type/Page>> endobj 432 0 obj <>stream If the hospital staff applies the cast, the facility will report the same code. Cover the cast while your child is eating to prevent food spills and crumbs from entering Casts and splints. The splint extends from the plantar surface of the great toe or metatarsal heads along the posterior lower leg and ends 2 inches distal to the fibular head to avoid compression of the common peroneal nerve (Online Figure G). The cells of your immune system rush to the injured area instantly. (2008). Inflammatory Phase: starts at the time of injury and lasts 1-2 weeks. Application. Position of Function. Functional cookies help to perform certain functionalities like sharing the content of the website on social media platforms, collect feedbacks, and other third-party features. The purpose of splinting acutely is to immobilize and protect the injured extremity, aid in healing, and lessen pain. We avoid using tertiary references. The skin wound may lie at a site distant to the fracture and not directly over it. inserts on the medial surface of metacarpal V; Flexes metacarpal V at carpometacarpal joint when little finger is moved into opposition with tip of thumb; deepens palm of hand. The most common radius and ulna fractures, with a summary of their management and indications for referral, are shown in Table 1. muscle contractions, and are effective at providing immobilization. There are different kinds and uses of digital thermometers. The cast is usually removed 4-6 weeks following your injury. Accidents can happen to anyone. A bar is placed between both legs to keep and tendons in place after surgery. After reduction, the wrist is flexed and the position held by dorsal moulding of the cast, at the level of the fracture. The skin under your cast may itch. the hot, itchy skin. fracture: [verb] to cause a fracture in : break. Splints are noncircumferential immobilizers that accommodate swelling. Splinting may be accomplished in a variety of ways. Do I need physical therapy while Im in the cast? CT scan. Undefined cookies are those that are being analyzed and have not been classified into a category as yet. One option is to begin as if creating a cast and, with the extremity in its position of function, apply stockinette, then a layer of overlapping circumferential cotton padding. (3 episodes, 2020) Mo Ali . In older people, especially those with osteoporosis, distal . The cast begins at the metatarsal heads and ends 2 inches distal to the fibular head. (2 episodes, 2021) . Label it and make sure its not used in the mouth. with a rectal temperature. After a night out on the town, a 21-year-old college student strikes an inanimate object. This is called reduction of the fracture. Casting involves circumferential application of plaster or fiberglass to an extremity. Prefabricated and over-the-counter splints are the simplest option, although they are less custom fit, and their use may be limited by cost or availability. It is mandatory to procure user consent prior to running these cookies on your website. In reduced, volar avulsion fractures, the splint is applied with the PIP joint at 45 degrees of flexion and secured at the proximal finger, allowing flexion at the PIP joint (Figure 6). It may pass The wrist is in a neutral position and slightly extended; the MCP joints are free. Tweet. wXNwc {5/u[pr2~{94[.sQ5K#3L.]a ! Orthopedic cast. Follow the product makers directions for correct This technology takes X-rays from a variety of angles and combines them to depict cross-sectional slices of your body's internal structures. Factors include: A compound fracture is a very serious injury. For one, they cant get wet, as this can cause the plaster to crack or disintegrate. If your child's cast has an abduction bar, don't use the abduction bar on the cast Whether or not you need an ambulance, you should always go to the nearest emergency department where healthcare providers will diagnose the compound fracture and plan your treatment. Indications and accurate application techniques vary for each type of splint and cast commonly encountered in a primary care setting. Dont use a mercury thermometer. Fractures of the di890stal radius are common injuries. Metacarpal Fractures are the most common hand injury and are divided into fractures of the head, neck, or shaft. Your doctor will take a number of factors into consideration when choosing the type of cast or splint to use in your treatment. These are the same as for a forearm splint. This swelling and redness can continue for some time as your body tries to ensure healing. Many health conditions can cause swollen fingers. If you have a disorder that interferes with blood flow, you may heal slower. Home; Dante Opera. They also take several days to fully harden, so youll need to limit your activities for a few days after getting the cast. However, if you have chronically swollen fingers with other symptoms, A shoulder arthrogram is an imaging test that can help diagnose hard-to-see joint issues. Casts are supportive devices used to help keep an injured bone in place while it heals. Its not something you should ever try to fix on your own. Some splints can be purchased ready-made, but others are custom made to fit a specific area. Next, theyll wrap several layers of soft cotton around the area before applying the paste. Waterproofing the cast will likely cost more and take more time, but it may be worth discussing with your doctor if you feel a waterproof cast will best fit your lifestyle. Applied around the trunk of the body to the shoulder, arm, and hand. Position of Function. margin-right: 10px; Menu. Your childs Check the skin around your cast often. Splints are often called half casts because they dont fully surround an injured area. This involves mixing white powder with water to form a thick paste. Find, Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. Splints are easily adjustable, so theyre often used to help stabilize the area until the swelling goes down. Ear temperatures are accurate after 6 months of age, but not before. endstream endobj startxref by. If the cast isnt waterproof, its difficult to get it dry again. For children younger than 3 years, a rectal temperature is the most accurate. 2005-2023 Healthline Media a Red Ventures Company. Theyre more porous than plaster casts, which allows your doctor to take X-rays of the injured area without removing the cast. The fiberglass is then soaked in water and wrapped around the area in several layers. An accident that causes a compound fracture is a frightening event. Boyd AS, et al. Coronavirus (COVID-19): Latest Updates | Visitation PoliciesVisitation PoliciesVisitation PoliciesVisitation PoliciesVisitation Policies | COVID-19 Testing | Vaccine InformationVaccine InformationVaccine Information. Application. Initial management is of . university avenue palo alto restaurants. Symptoms include pain, numbness and weakness in your wrist and hand. } Examples of events that can cause this type of severe trauma include a: A broken bone is a compound fracture if it breaks through your skin. Here's what causes them and how they're treated. Low-energy or high-energy mechanisms may be involved. Common Uses. Your age. Plaster casts used to be more common A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. Fractures can also be caused by diseases that weaken the bone. Mouth (oral). Youll need surgery to realign your bones and then a cast to keep them immobilized. -Cast change or removal -Removal of external or internal fixation devices -Medication adjustment -Follow up visits following fracture treatment 10 also used to hold the hip or thigh muscles and tendons in place after surgery. Also used to hold the arm or elbow muscles Ulnar side of hand. Until the 1970s, the most common type of cast was made with plaster of paris. If they are, use tape and gauze or another thin, soft material to prevent the rough or sharp edges from hurting your skin. The most common types of splints and casts used in primary care, with information on indications and follow-up, are discussed in Table 2, Table 3, andTable 4. Common Uses. For example, a simple buckle fracture will need a plaster cast for 2 to 3 weeks and be almost completely healed in 4 weeks. Management of Emergency Department Patients with Boxers Fractures: Functional Treatment or Immobilization. and without motion. the hips and legs immobilized. sound like "cobra." Anyone come across this one? Other fractures might need just a cast or just a splint. The cast extends from the proximal one third of the forearm to the distal palmar crease volarly and just proximal to the MCP joints dorsally (Online Figure D). To bathe with a plaster cast, youll need to wrap it in several layers of plastic. If you see redness or drainage, or if your skin is sore, contact your healthcare provider. The length of time taken for healing depends on where the fracture is and how severe the break is. font-weight: normal; Common Uses. But it grows stronger as it calcifies and develops into normal bones over weeks to months. A 2016 retrospective cohort study at a tertiary care PED found that among patients 9 months to 3 years of age with radiographic evidence of toddler's fractures, 66.7% were placed in splints or casts, 24% were placed in CAM boots, and 9.3% were not immobilized. A bar Prepackaged splints consisting of fiberglass and padding wrapped in a mesh layer also exist. An acceptable alternative is to create a splint without the use of stockinette or circumferential padding. Common Uses. Continuous extension in the splint for six to eight weeks is essential, even when changing the splint. Minerva cast. Therefore, meticulous evaluation and follow-up are essential. A second sugar-tong splint is then applied, extending from the deltoid insertion distally around the 90-degree flexed elbow, and proximally to 3 inches short of the axilla (Figure 9). Snapping ECU is a clinical condition characterized by pain over the ulnar wrist caused by instability and tendonitis of the ECU tendon secondary overuse. Prevent small toys or objects from being put inside the cast. Buddy taping should follow. While they arent as popular as they used to be, plaster casts still have some advantages. Application. Performance cookies are used to understand and analyze the key performance indexes of the website which helps in delivering a better user experience for the visitors. Discussion of the case with local hand or orthopaedic surgeon, will develop treatment plan and follow up, and will generally guide further management. 454 0 obj <>stream (2014). Children heal in about half the time it takes an adult to heal from a similar injury. Pearls/pitfalls. surgery to allow healing. Therefore, any fracture that has a concomitant wound should be considered open until proven otherwise. Keep the following tips in mind for proper cast care: Your healthcare providers will give you instructions when you leave the emergency department. Telephone +61 3 9345 5522 . After surgery on the neck or upper back area. This works for children age 3 months and older. Unstable distal radius fractures present a challenge to the treating orthopaedic surgeon. Proper . Stress fractures are common in children who run . When determining whether to apply a splint or a cast, the physician must make an accurate diagnosis, as well as assess the stage, severity, and stability of the injury; the patient's functional requirements; and the risk of complications (Table 1).1,2, Acute and definitive treatment of select fractures, Acute management of injuries awaiting orthopedic intervention, Commercial splints available and appropriate for select injuries, May be static (preventing motion) or dynamic (functional; assisting with controlled motion), Not useful for definitive care of unstable or potentially unstable fractures, Definitive management of simple, complex, unstable, or potentially unstable fractures, Severe, nonacute soft tissue injuries unable to be managed with splinting, Because splints are noncircumferential immobilizers and are, therefore, more forgiving, they allow for swelling in the acute phase. The splint stabilizes the wrist elbow and limits, but does not eliminate, forearm supination and pronation. Copyright 2009 by the American Academy of Family Physicians. You also have the option to opt-out of these cookies. During surgery your bones may be aligned using hardware devices, including: Your bones will then be immobilized in a cast or other device. A high clinical suspicion should be used when assessing these injuries. Always go to the emergency department if you think you have a broken bone. Therefore, they are usually reserved for complex and/or definitive fracture management. Definitive treatment of injuries to the ankle and foot. iezou.com. Severe fractures occur if angulation is greater than 45or if rotation is greater than 20 external reduction is required. Simple Analgesia= Paracetamol-codeine, NSAIDs. Overuse or repetitive motions can cause stress fractures. Compound fractures are extremely painful. The splint extends from the lateral mid-calf around the heel, and ends at the medial mid-calf (Online Figure H).16 The position of function is with the ankle flexed to 90 degrees (neutral). Should I see any other specialists (like an orthopaedic surgeon or neurologist)? Part of the treatment for a fracture in your body is immobilization, which often comes in the form of a cast or splint. to lift or carry the child. The forearm is neutral and the wrist is slightly extended. #mc-embedded-subscribe-form .mc_fieldset { Cobra (TV Series 2020- ) cast and crew credits, including actors, actresses, directors, writers and more. ANSWER:1, 2, 3. Symptoms include pain and swelling of a deformed joint. (5 episodes, 2020-2021) Hans Herbots . For example, a child with a forearm fracture will have a long Use a hair dryer set on a warm to hot setting to dry the cast. This can help prevent swelling. CT scans can uncover wrist fractures that X-rays miss. Not playing contact sports like football. Definitive treatment of injuries initially treated with a posterior splint. arm cast to immobilize the wrist and elbow joints. In general, 2-inch padding is used for the hands, 2- to 4-inch padding for the upper extremities, 3-inch padding for the feet, and 4- to 6-inch padding for the lower extremities. Metacarpal Fracture Closed Reduction and Pinning, Metacarpal DCP Plating for Transverse Fracture, Metacarpal Neutralization Plate with Lag Screw Fixation for Short Oblique Fracture, Metacarpal Lag Screw Fixation for Long Oblique and Spiral Fractures, Type in at least one full word to see suggestions list, Cleveland Combined Hand Fellowship Lecture Series 2021-2022, Cleveland Combined Hand Fellowship Lecture Series 2020-2021, Metacarpal Fractures & Dislocations: Case of the Week - Joanne Wang, MD, Metacarpal Fracture: Case of the Week - Jessica Churchill, MD, Question SessionMetacarpal Fractures & Pediatric Lateral Condyle Fractures, Metacarpal nonunion with hardware failure in 23M. Mercan, S. et.al. Tips to keep body casts clean and dry and prevent skin irritation around the genital Eventually, the paste hardens into a protective case. #mergeRow-gdpr { Ulnar gutter, radial gutter, thumb spica, finger, Posterior knee, off-the-shelf immobilizer, Posterior ankle (mid-shaft and distal fractures), bulky Jones, Long leg (proximal fracture), short leg (mid-shaft and distal), Posterior ankle (post-mold), stirrup, bulky Jones, high-top walking boot, Posterior ankle with or without toe box, hard-soled shoe, high-top walking boot, Short leg, short leg with toe box for phalanx fracture, Fourth and fifth proximal/middle phalangeal shaft fractures and select metacarpal fractures, Proper positioning of MCP joints at 70 to 90 degrees of flexion, PIP and DIP joints at 5 to 10 degrees of flexion, Second and third proximal/middle phalangeal shaft fractures and select metacarpal fractures, Thumb, first metacarpal, and carpal bones, Fracture of the middle/proximal one third of the scaphoid treated with casting, Nondisplaced proximal/middle phalangeal shaft fracture and sprains, Encourage active range of motion in all joints, Encourage active range of motion at PIP and MCP joints, Middle phalangeal volar plate avulsions and stable reduced PIP joint dislocations, Increase flexion by 15 degrees weekly, from 45 degrees to full extension, Extensor tendon avulsion from the base of the distal phalanx, Continuous extension in the splint for six to eight weeks is essential, Consider splinting as definitive treatment for buckle fractures, Nondisplaced, minimally displaced, or buckle fractures of the distal radius, Used for increased immobilization of forearm and greater stability, Elbow, proximal forearm, and skeletally immature wrist injuries, Distal humeral and proximal/midshaft forearm fractures, Ensure adequate padding at bony prominences, Acute elbow and forearm fractures, and nondisplaced, extra-articular Colles fractures, Offers greater immobilization against pronation/supination, Splint ends 2 inches distal to fibular head to avoid common peroneal nerve compression, Isolated, nondisplaced malleolar fractures, Refer for displaced or multiple fractures or significant joint instability, Mold to site of injury for effective compression, Compartment syndrome most commonly associated with proximal mid-tibial fractures, so care is taken not to over-compress, Refer for displaced or angulated fracture or proximal first through fourth metatarsal fractures, Weight-bearing status important; initially nonweight bearing with tibial injuries, Acute soft tissue and bony injuries of the lower extremity, If ankle immobilization is necessary, as with tibial shaft injuries, the splint should extend to include the metatarsals, Distal metatarsal and phalangeal fractures, Often used when high-top walking boots are not available, Refer for displaced or unstable fractures.
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