This splint only prevents flexion/extension and ulnar/radial abduction of the wrist.
Material
- Stockinette; select the appropriate size.
- Synthetic wadding.
- Plaster rolls; select the appropriate width; it should be wide enough to form half a cylinder. Remove the plaster rolls from the packaging.
- Absorbent bandage, to fix the plaster.
- Crepe bandage or cambric bandage to finish off, if necessary.
- Bandage scissors.
- Bandage hook fasteners or plasters.
- Sling or collar’n’cuff.
Procedure
- Fill a small bucket with lukewarm water (around 20° C) and place this as close to the treatment table as possible.
- Ask the patient to sit at the treatment table with the arm in the position in which is to be immobilised.
- The elbow should be at a 90° angle, and the wrist should be in slight dorsal flexion.
- Determine the required length of stockinette (1.5 x the length of the actual plaster bandage).
- Slide the stockinette over the arm and cut a hole for the thumb.
- Place a layer of padding all around, and an additional layer on pressure-sensitive points.
- Cut a hole for the thumb.
- Partially unroll the plaster bandage and measure the length of the splint by holding it along the forearm.
- Fold the unrolled plaster bandage into 5 to 6 layers.
- If using pure plaster of Paris, 10 to 12 layers will be necessary.
- Cut away a triangle for the thumb.
- Fold the layers of plaster bandage and submerge them under water until no more air bubbles are released.
- If the plaster bandage is held at an angle, a few seconds may be sufficient [Figure 118].
Figure 118
- Remove the plaster bandage from the water and gently squeeze out any excess water [Figure 119].
Figure 119
- Stretch out the plaster splint and place it along the dorsal side of the forearm and wrist.
- Keep the metacarpal joints free [Figure 120].
Figure 120
- Ensure that the wrist remains in dorsal flexion at an angle of 15° while moulding the plaster cast.
- Avoid making indentations with your fingers (be mindful of the risk of pressure necrosis).
- Apply a wet absorbent bandage all around the newly moulded plaster cast.
- Make sure that the joint is maintained in the correct position throughout, until the plaster has hardened [Figure 121].
Figure 121
- Inform the patient that heat will be given off during the hardening process.
- To finish off, a cambric or crepe bandage can be applied (if required) [Figure 122].
Figure 122
- Once the plaster cast has hardened, apply a sling or collar’n’cuff.
- Tell the patient that it will be at least another 24 hours before the plaster is hard enough to take a knock.
- Ask the patient to inform you immediately if the fingers on the immobilised arm turn blue or pale.
- Instruct the patient to regularly move their fingers [Figure 123].
Figure 123