OCDT 4024

MODALITIES OF
IMMOBILIZATION

SPLINTS
KUMPULAN 7 ADOC 1/2023
MOHD HAFIZ BIN ABDULLAH RIJAL
NUR ALWANNI BINTI YUSOFF
NAFIZAH BINTI ISMAIL 09/26/23 1
 WHAT IS IMMOBILIZATION?
• The process of stopping something or someone from
moving.
• ITS ALSO A HEALING PROCESS
• Holding an injured joint or bone in place with a splint, cast,
or brace to prevent movement while healing PROCESS
OCCUR

09/26/23 2
 DEFINITION OF SPLINTS

• A splint is a rigid support with padding made from

metal, plaster or plastic.It is secured in place with
an elastic bandage or an ACE wrap
• To support, protect or immobilize an injured or
inflamed part of the body
• To prevent movement of the injured extremity and
to minimize pain
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 INDICATIONS
• Fractures
• Sprains
• Joint infection
• Tenosynovitis
• Acute arthritis/gout
• Lacerations over joint
• Reduce and prevent contracture
• To correct deformity
• To stabilize and rest joint in ligamentous injury
• To support and immobilize joints and limbs postoperatively
until healing has occured. 09/26/23 4
 CONTRAINDICATIONS

• Compartment syndrome
• Skin at high risk infection
• Need for open reduction

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 TYPE OF SPLINTS
• ITS DIVIDE INTO THREE MAJOR PART OF BODY :
-UPPER LIMB SPLINTS
-LOWER LIMB SPLINTS
-SPINAL SPLINTS

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 TYPE OF SPLINTS
UPPER LIMBS

•Shoulder and arm

-Figure of eight
-Arm sling
-Aeroplane splint

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• Elbow / forearm
- Long arm posterior
splint
- double sugar tong Long arm posterior splint

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Double sugar tong

• Forearm/wrist
- Volar forearm / cockup
Volar forearm /cock up

- Sugar tong

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Sugar Tong
• Hand / fingers
- Ulna gutter
- Radial gutter
- Thumb spica splint
- Finger splint eg: buddy splint
ulna gutter
- Knuckle bender splint radial gutter
- Zimmer splint

thumb spica splint

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finger:buddy splint
knuckle bender splint Zimmer splint
Lower limb splint

• Hip and thigh

- Von rosen’s splint
- Thomas splint
- Bohler-braun frame

Bohler- braun frame 09/26/23 11

Thomas splint
• Knee
- Knee
immobilizer/Bledsoe
- posterior knee splint
Knee Immobilization

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Posterior knee splint

• Below knee slab

Below knee slab

• Boot slab

Boot slab 09/26/23 13

• Ankle
- Posterior ankle
- Ankle stirrup splint

Posterior ankle

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• Foot
- Denis-brown splint
- Buddy splint

Denis-brown splint

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Buddy splint
• SPINE
- Cervical collar
- Minerva brace
- SOMI (Sternal Occipital cervical collar

Mandibular Immobilizer)

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SOMI Minerva brace

• Taylor's brace
• Juwett brace
• Scoliosis brace
JUWETT BRACE
(Milwaukee brace
and boston brace)

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MILWAUKEE BRACE BOSTON BRACE

 PRINCIPLES OF SPLINTING

• 8 Essential Splinting Principles:

1. Follow patient’s Anatomy

• The orthotic design must consider the unique patient’s hand

anatomy and the functional requirements of the patient.
• Supporting the curvature and angles of the metacarpal arch,
materials should:
• Allow for the oblique line of the distal palmar crease.
• Be sensitive to sensory input from the palmar surface of the hand.
• Accommodate the physiological position of rest 09/26/23 18
2. Adjustability

• A well-designed splint should not only meet the needs of

the patient’s problem mechanically. It should also be
adjustable so it can be modified to fit the patient’s status.
• Make custom orthoses to meet the needs of their patients,
as well as being able to modify commercially available
orthoses if they are not fitting correctly.
09/26/23 19
3. Reassessment

• To set up a future appointment at the time of supplying the

original splint. This would allow to make sure the splint still
fulfills its purpose and fits well.
• Important to evaluate the patient’s status during the initial
fitting and fabrication of the orthosis.
• Make sure re-evaluate the patient over time, so you will know
if the orthosis still fits correctly and is, in fact, still necessary.
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4. Convenient

• Simplicity is key.
• A splint should be simple, made with materials
cosmetically acceptable to the patient, and follow the
contours of the hand.
• All orthoses must be well-designed and carefully
constructed.
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5. Prevent pressure points
• Points of pressure must be addressed. Do this either by bumping
out the material or applying some padding. In addition, distribute
the material over as wide an area as possible. Blanching of the skin
or noted areas of numbness indicate compression, which must be
corrected.

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6. Ensure comfort and keep pain free
• Patient should be comfortable and pain free in the proposed orthosis
• Depend on the condition of each patient and diagnosis.
• Patient should understand the wearing schedule and full benefits of orthosis
provide.

7. Avoid complication to non affected joint

• It is essential to be aware of the concept of lever arms.
• Forearm splint should include 2/3 the length of the forearm, and not interfere
with elbow flexion.
• The joint is usually considered as a fulcrum and the load arms or lever arms
are as long as possible to support the joint. Positioning, axis of motion, angle,
and length of lever arms all are important factors in orthotic fabrication.
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8. Method and assesment
• Help to develop a critical approach for assessment and
reassessment regarding fit and function.
• Keep up to date with the quality and characteristics of the
many materials used in orthotic fabrication.

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 TECHNIQUE APPLICATION

• UPPER LIMB
1) Figure of eight
- For clavicle fracture
- Apply with patient standing and
hands on iliac crest,shoulder in
abducted position

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2. Arm sling
- For shoulder and humerus
injuries.
- To support weight of shoulder.
- Place the injured arm in the
sling with the elbow at 90
degrees of flexion.
3. Aeroplane splint
- For brachial plexus injury.
- Maintaining axilla in 90
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degrees position.
• ELBOW
1.Long arm posterior splint
- For distal humerus fracture
- Olecranon fractures.
- Radial head fracture

2. Double sugar tong

- Apply from palmar crease, wrapping
around lateral metacarpals extending
up to posterior arm with elbow flexed
at 90 degrees.

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• Forearm splint

1. Volar splint/ Cockup

- Distal forearm and wrist

fractures.
- Soft tissue/ wrist injuries
- Apply from volar palmar
crease to 2/3 forearm.
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2. Sugar tong
- For wrist and distal forearm
fractures.
- Extend from MCP joint on
dorsum of hand,tracks along
the forearm,wraps around
back of elbow to volar surface
of the arm and extend down to
mid palmar crease.

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• Hand / fingers
1.Ulna gutter
- for 4th and 5th metacarpal
fracture.
- Apply along the ulna side of
the forearm and hand to
immobilize the 4th and 5th
finger.
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2. Radial gutter

- Used to immobilize the

fracture fragments in the
index (second) and the
middle (third) fingers.
- Fingers line along the side
of the radius bone, the splint
is called the radial gutter
splint.
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3. Thumb spica splint
- For scaphoid fracture.
- Extend from DIP joint of
thumb, incorporates the
thumb and extends up to
2/3 of the proximal lateral
forearm.
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4. Buddy splint
- A buddy tapping a finger dinamically
splint one finger to an uninjured finger.
- For minor finger injuries such as sprains
or strains.

5. Knuckle-bender splint
- For ulna nerve palsy.
- Flexes the metacarpal phalangeal (MCP)
joints of all finger without blocking
interphalangeal (IP) or wrist motion. 09/26/23 33
• Hip and thigh
1.Von Rosen splint
- For congenital dislocation of the hip.
- To held hip in flexed and abducted position.

2. Thomas Splint
- Used for immobilization of hip and thigh
fractures.
- The length is the measurement from the
highest point on the medial side of the
groin up to the knee plus 6 inches. 09/26/23 34
3. Bohler-braun frame

- More convenient than thomas

splint because it has no ring.
- Built in system of counter
traction and not suitable for
transportation.

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• Knee

1. Knee immobilizer/Bledsoe
- For proximal tibia/fibula
fracture.
- Place knee in full
extension,the plaster is placed
from the middle thigh to 3
inches above level of bilateral
malleolus.

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• Ankle
1. Posterior ankle
- Placed from metatarsal heads on
plantar surface foot,extend up back
of leg to level of fibular neck.

2. Ankle stirrup splint

- Similar to posterior splint.
- Great for ankle sprains.

09/26/23 37
• Foot
1) Denis-brown splint
- For congenital talipes equino varus.
- Used after successful correction of
deformity,to prevent relapse.
- Used until child start walking
2) Buddy Tapping
- For phalangeal fractures of the toes.
- Small pieces of wadding placed between
toes to prevent maceration. 09/26/23 38
• SPINE

1) Cervical collar
- Flexible
foam/rigid/adjustable collar.
- Encircles the neck to
support the skull against the
thorax inferiorly.
- Post operative
immobilization.
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2) Minerva brace

- More stable than cervical collar.

- Applying pressure to
mandible,occiput,sternum,and
upper thoracic spine.

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3) SOMI (Sternal Occipital Mandibular
Immobilizer)

• For C4/5- T3/T4 stable fracture

• For weak rheumatoid arthritis spine.
• A SOMI brace consists of a metal chest section,
shoulder bands and upright bars that connect to
the pads at the back of the head and under the
chin. It is held in place by the shoulder straps that
cross at the back and fasten to the chest section.
• It comes in two sizes but is totally adjustable to
allow for a comfortable and accurate fit to keep 09/26/23 41

the head in the prescribed position

4) Taylor's brace - provides firm support to
the thoracic spine and straightens the curve.

5) Scoliosis brace (Milwaukee brace and

boston brace)- non-operative treatment of
scoliosis and kyphosis
- Fits snuggly over the pelvis below,chin and
head pad promote active postural correction
and thoracic pad presses on the ribs at the
apex of the curve.
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 REFERENCES
• Mahatma Gandhi Hospital Parel Mumbai Follow. (n.d.). Splint PPT by rupeshkumar. Share and
Discover Knowledge on SlideShare. Retrieved March 27, 2023, from
https://www.slideshare.net/vhjokhi/splint-ppt-by-rupeshkumar
• 8 essential splinting principles. Orfit Industries. (2022, July 5). Retrieved March 27, 2023, from
https://www.orfit.com/blog/8-essential-splinting-principles/
• Splints and casting techniques - ppt download. SlidePlayer. (n.d.). Retrieved March 27, 2023,
from https://slideplayer.com/slide/16423907/

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THANK YOU FOR LISTENING

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