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1
SLINGS
COLLAR AND CUFF
Indications:
• Fractures of humerus including head / neck fractures to allow
gravity from the weight of the arm to disimpact the fracture
• Radial head fractures of the elbow
• Long term / comfortable sling (as opposed to the ‘triangular
bandage’ broad arm sling)
• This method should
ALWAYS be used if the
patient has sustained a
fracture to the head / neck
of the humerus
Adapted version
The second loop around the elbow
can come across the back or
around the neck and down the
front, dependant upon patient
comfort and aim of sling
Useful for clavicle fractures to
avoid direct friction to the fracture
site
Remember to always trim the
plastic ties, and secure down
with tape to avoid scratching
the patient
2
BROAD ARM SLING
Indications:
• First aid – Acts as support, splint and provides elevation to prevent
swelling for arm injuries and lacerations
• To support an arm in a cast and to provide elevation to same
• Temporary elevation
Step 4.
Triangular bandage rules
(Regardless of which sling type performing)
• Long side to un‐injured side of the body
• Opposite point to the injured elbow
• Always place arm bent above 90 degrees to allow
elevation (unless unable e.g. elbow injury)
• Secure at elbow to provide a ‘cradle’ for the arm
Tie around the neck,
ensuring position of the
arm, and secure around
the elbow
3
HIGH ARM SLING
Indications:
• First aid – High elevation for severely swollen extremities (all causes), and active
bleeding
• Temporary high elevation e.g. patient requires strict elevation for a short period
‐ Infection to hand / arm
‐ Wounds that are at risk of further bleeding (to prevent ‐ haematomas)
Lay the sling OVER the Tuck under the elbow and
Place arm with finger tips
arm, as per triangular bring the remaining fabric
touching opposite
bandage rules across the back
shoulder
Step 5
Step 4
Apply safety pin to the
Tie across the back elbow to secure
Caution:
Once this sling is removed, it is impossible to self re‐apply.
Therefore consider:
- Do they need to wear the sling for longer than a day?
(Check with the practitioner treating the patient)
- Do they seem that they may be non compliant with a high
arm sling?
-
If the answer to any of the above is yes, treat in a Stockinette high arm sling
4
STOCKINETTE HIGH ARM SLING
Indications:
• As for high arm sling
• Non compliance or inability to cope with the ‘triangular bandage’ high arm sling
• First aid – High elevation for severely swollen extremities (all causes), and active
bleeding
• Short term high elevation e.g. patient requires strict elevation for the day
‐ Infection to hand / arm
‐ Wounds that are at risk of further bleeding and to prevent – haematoma
formation
Step 1.
Cut small hole in centre of arm width piece of stockinette
Step 2.
Place arm through hole and tie at the back,
Ensuring the fingers are not restricted
Caution:
Stockinette is a loose fitting elasticated bandage (usually used as a liner under Plaster
of Paris). This does not constrict the arm.
NEVER use tubigrip as an alternative to stockinette in the application of a sling, or as a
liner under Plaster of Paris. This provides compression, and could lead to neuro‐
vascular compromise.
Care giver should be advised to remove child’s hand every two hours to exercise their
wrist and hand to prevent stiffness, and to check the perfusion of their fingers.
5
SPLINTS
BUDDY (NEIGHBOUR) STRAPPING
Indications:
• Stable, non complicated finger or metacarpal fractures, or minor soft tissue
injuries
Contraindications:
• Unstable finger or hand fractures
• Severe soft tissue injuries
• Widespread skin maceration / abrasions
Alternatives:
(should always be discussed with the practitioner treating the patient)
• Coban tape or mefix as an alternative to elastoplast if known allergy
• Zimmer (Aluminium) splints
• Prelude fibreglass plaster splint
Tubigrip buddy strapping
• Good for simple soft tissue injuries of the hand as
allows movement / exercises
• Can be used for simple fractures
• The size of the splint should be assessed, ensuring
Tubigrip buddy strap
that it is supportive, but does not cause constriction
Elastoplast buddy strapping
• Check if the patient is allergic to elastoplast
prior to application
• Coban bandage or mefix may be used as an
Elastoplast buddy strapping alternative if the patient is allergic
• Take care to ensure the tape is not applied
too tightly to avoid neurovascular
compromise
• The injured digit is strapped to the adjacent
finger, above and below the PIP joint. A small
piece of gauze should be placed between the
fingers to act as a pad, and prevent friction
Coban buddy strapping
• The patient can be educated how to self care
and change the strapping at home to avoid
maceration
Caution:
Always enquire as to the side / site of the injury, and ensure the finger is always
strapped to the finger on the side of the injury. Eg: collateral ligament sprains – if
sprained / ruptured on the ulna aspect, strap to the finger on the ulna aspect for
support and protection (prevents lateral stress)
6
ZIMMER (ALUMINIUM) SPLINTS
Indications:
• Unstable finger or metacarpal fractures or soft tissue injuries
• Post reduction of complicated finger / metacarpal fractures /
dislocations
• If mallet splint or buddy strapping contraindicated