Treatment of Fractured Bones with Splints

Treatment of Fractured Bones with Splints

Why do we need to use splints or temporary casts?

To help support the injured bones and muscles, reduce pain, swelling, and muscle spasm, prevent the relocated bones from moving incorrectly again. The splint that is used may be a temporary half-cast or a full-arm cast. The temporary half-cast is less strong than the full cast.

Types of Splints

Currently, there are 2 major types of splints to choose from:

1. Plaster splint, which is a plaster-coated gauze. Once applied, it will become white.

Advantages:

Relatively low cost, easy to apply and remove the splint.

Disadvantages:

Relatively heavy, easily broken, poor air circulation may cause itching, and if wet, the splint will become loose and less strong.

2. Plastic splint, which is a synthetic plastic.

Advantages:

Lightweight, good air circulation, beautiful color, high strength. Also, when taking X-ray photos, the bone can be seen more clearly.

Disadvantages:

Expensive (6-7 times more expensive than plaster splint), difficult to cut and mold the splint. It requires removal and replacement of the splint.

How to apply the splint?

• Before applying the splint, the doctor will wrap a padding around the affected area. The splint should be tightly secured and fitted to the arm or leg. Generally, the splint is applied from below the fractured bone to above the broken bone.
• A temporary splint will be used during the early stages of swelling. When the swelling goes down, a full splint can be applied. Sometimes, after a few weeks (about 2 weeks), the splint may become loose due to a decrease in swelling, and a new splint may need to be applied. After the bone begins to heal (about 4-6 weeks), a temporary splint can be used for convenience during physical therapy.

How to reduce swelling?

In the first 48-72 hours, swelling may cause pressure on the splint, resulting in tightness, numbness, and pain. To reduce swelling, you can:

• Elevate the arm or leg above heart level, such as by placing it on a pillow or cloth.
• Move your fingers or toes frequently.
• Apply cold compresses to the affected splint area by using ice in a dry plastic bag and compressing it around the splinted area.
• A single cold compress point may not be effective.

Seek urgent medical attention if there are danger signs after inserting or temporary splinting.

• If there is increased pain and tightness in the splint, it may be due to swelling.
• Numbness and tingling in the hands or feet may occur due to excessive pressure on the nerves. Pain and warmth may occur due to excessive pressure on the skin. Swelling below the splint edge may indicate poor blood circulation.
• Inability to move fingers or toes is also a concerning sign.

Caring for a permanent or temporary splint involves:

• Keeping it dry at all times. If you want to take a bath, cover the splint with two layers of plastic bags, and tie the mouth of the bag tightly to prevent water from getting inside the splint.
• Do not put weight on the splint until it is completely dry and hard, which may take an hour for a plastic splint and 2-3 days for a plaster splint.
• Avoid getting dirt, sand, or dust inside the splint.
• Do not pull out the padding inside the splint
• Do not use any object to scratch inside, or put powder inside the splint. If there is severe itching, see a doctor.
• Do not cut the edges of the splint yourself.
• Monitor the skin around the splint, and seek medical attention if there is redness or swelling. Check the splint frequently, and seek medical attention if it is cracked or broken. If you need to remove the splint, seek medical attention.

Splint removal

It is not recommended to remove the splint by yourself as it may cut the skin or cause bone healing problems. When removing the splint, a doctor will use a saw to cut the splint, which will vibrate sideways (not rotate) and when the saw touches the padding under the splint, it will not damage the skin. Sawing the splint may cause a loud noise and a warm sensation from the friction, but it will not be overly dangerous.

Treatment:

• Generally, if there are no problems, the doctor will schedule a follow-up examination about 1-2 weeks after putting on the splint to assess the condition and see if the splint is loose. If the splint is loose, an X-ray may be required and the splint may need to be replaced. If the splint is tight and strong, the doctor will schedule a follow-up X-ray every 1-2 months until the bone is fully healed.

• The splint will be left on for approximately 4-6 weeks, but it will take 4-6 months for the bone to fully heal. Therefore, even if the splint is removed, the broken bone may still be fragile and precautions should be taken and the doctor's instructions should be followed. Otherwise, the bone may break again, requiring a new round of treatment.