FIRST

AID

SPLINTS
PRESENTED BY,
SHINI
NURSUNG TUTOR
PNS
 SPLINT
S

SPLINTS
A splint is a rigid appliance, usually made of wood or metal, which is tied to a fractured limb to support it and
prevent movement from taking place at the site of fracture.
Using a Splint
If a splint is not used properly, it may cause damage. Therefore, remember the following points when using a splint:-
1. Make sure that the splint is well padded. This is particularly important when splints are improvised from pieces of
wood which are uneven.
2. Make sure that the splint is sufficiently long to immobilize the joint above and the joint below the fracture.
3. Make sure that the bandage used to secure. The splint have the knot tied on the splint and not on the fleas
 IMPORTANT SPLINTS IN ORTHOPAEDIC OTHER
THAN PLASTER SPLINTS

 Splints occupy a very special place in the treatment methodologies in orthopedics.

 Any material which is reasonably hard like a rolled newspaper, card board, wooden planks, books, etc.
can function as a splint.
 However these are crude and are mostly useful during first aid treatment of bone and joint injuries.

Refined splints used in orthopaedics are

 plaster of Paris splints.
 Thomas splints.
 Bohler-Braun splints.
 Aeroplane splints.
 PLASTER
SPLINTS

1.Thomas Splint
 This is one of the very commonly used
splints in orthopedics.
 It was discovered by H.O. Thomas in
1876 to assist for ambulatory treatment of
TB knee.
 It is now widely used for the treatment of
shaft fractures of femur, knee injuries etc.
 PARTS OF A THOMAS
SPLINT

A Thomas splint consists of four parts

1. A padded metal oval ring with soft leather set at an angle of 1200 to the inner bar.
2. Two side bars-one inner and another outer bars of equal length. They bisect the oval ring.
3. Distal end-where the two side bars are joined in the form of a ‘W'.
4. Outer side bar is angled 2 inches below the padded ring to clear the prominent greater trochanter.
 USES OF THOMAS
SPLINT

1. To immobilize fracture femur anywhere.

2. As a first aid measure to immobilize the lower
limb injuries.
3. For transportation of an injured patient.
4. In the treatment of joint diseases like TB knee,
septic arthritis etc.
 BOHLER-BRAUN (BB)
SPLINT
This is Bohler's modification of Braun splint.
It consists of a heavy metallic frame with four'
pulleys:-
1. Proximal pulley prevents foot drop.
2. Second pulley to apply traction in the line of femur.
3. Third pulley to apply traction in the line of
supracondylar area of femur.
4. Fourth pulley to apply traction in line of the legs.
 INDICATION
S

 Skeletal traction is applied through this frame for comminuted

trochanteric fractures of the femur.
 It is also used for the treatment of fracture shaft femur and
supracondylar fractures of the femur.
 Rarely it can be used for the fracture shaft of tibia and fibula.
 One important precaution which should be taken while using
the BB splint is to provide support at the fracture site and not at
the knee joint to prevent angulation especially in supracondylar
fractures of femur.
 PROBLEMS OF BB
SPLINT

1. Makes nursing care difficult.

2. It is a heavy and cumbersome frame.
3. It is associated with recumbent problems
like bedsores ,hypostatic pneumonia, renal
calculi, etc. 
 PNEUMATIC
SPLINTS

 These are the present generation splints and are

more aesthetic, light and effective.
 They consist of the splints made up of pneumatic
material and can be easily applied to the limbs by
inflating it with air.
 They provide a tight fit and are more comfortable to
the patient.
 Most of the ambulances today carry these splints
which are easy to transport unlike the crude and
hard Thomas splints, etc.
 CARE OF THE SPLINTS BY THE
NURSE

1. Padding- The splint should ,be well padded at the bony

prominences and at the injury sites.
2. Bandage- This should be tied with optimum pressure.
3. Exercises -Active exercises of the joints and muscles
should be permitted within the splints.
4. Checking -Daily checking and adjustments of the
splints are recommended.
5. Neurovascular status- Distal neurovascular status
should be assessed daily.
 NURSING CARE FOR PATIENTS TREATED WITH
SPLINTS

Nursing care assumes extreme importance in patients treated with splints as most of these patients are severely
injured and are bed ridden. This can be discussed under two headings:

A}-NURSING CARE BEFORE APPLICATION OF THE SPLINT

 Take consent.
 Inform the patient about the procedure.
 Remove any tight fitting clothes and change them into easy to wear dresses.
 Clean the affected part.
 Select right sized splint.
 Adequately pad the pressure points and the perineum.
 Apply the splint gently.
 Continue…

 Check for the tightness of the weight cord.

 After application check for the peripheral pulses and nerve function.
 Apply proper weight as per the directions of the surgeon.
 Foot end elevation may be required to give the counter traction.

 Note:
Maximum permissible weight limits:--
a. Skin traction-4-5 kg
b. Skeletal traction-8.10 kg
 B}-NURSING CARE AFTER APPLICATION OF
THE SPLINT

 Check the pressure points and perineum everyday for abnormal pressure.
 Tighten the weight cord arid increase or decrease the weight as per the advise of the doctor.
 Bed pan and urine can has to be given with care to avoid disturbance to the injured site.
 Care of the back is very important to prevent bedsores .
 Sponge bath the patient everyday.
 To prevent soiling of the bed sheets and the bed but proper rubber sheets.
 Attend to the hair and nails of the patient.
 Arrange to supply proper diet to the patients being treated on splints.
 Instruct the patient to carry out active exercises of the unaffected joints.
 Continue…

 Isometric exercises for the immobilized joints.

 Change the splint if the canvas gets soiled.
 If traction, either skin or skeletal, is applied
through the splint then the nursing care should
proceed on the lines described for treatment on
traction.