Short Leg Splinting

00:07 Hi there, welcome to Skills on Point intro to splinting course.

00:11 In this video, we'll be demonstrating to you a Short Leg Splint with a 3M Scotchcast.

00:17 My name is Michael Karg.

00:18 I'm a physician assistant in orthopedic surgery specializing in trauma.

00:23 What I'm going to teach you here today is to how to safely apply a short leg posterior roll splint using fiberglass material scotchguard type.

00:32 What I like to do is to have all my materials available right at the table so we don't not have to run around while the patient's getting her ankles splinted.

00:42 So we have our fiberglass material, we have our scissors, water basin, ace wrap, stockinette.

00:51 When we get ready to apply the splint, I've kind of pre-cut a stockinette to the patient's leg.

00:56 We're gonna go ahead and put that on.

01:23 So now we're ready.

01:24 We want to have the patient just relaxed.

01:26 We're eventually going to want her ankle at neutral, so 90°.

01:30 If you don't do that, then the patient's in a splint for, you know, 10 to 14 days, they can get an Achilles tendon contracture because their ankles plantar flexed.

01:40 We want to focus on this 90° angle.

01:43 Sometimes that can be uncomfortable for the patient as they have a broken ankle and they don't really want to do that.

01:48 But try and focus on that, very important.

01:52 Now we're ready for our splint.

01:53 We have everything ready to go, our waters ready.

01:58 Just a quick little measurement.

02:03 So we can cut this down a little bit here.

02:06 We don't need the full length.

02:20 Always cut a little bit off the inside here, so that we don't have any of this against the patient's skin.

02:34 Now we're ready to dunk.

02:36 Immerse the splint material in water.

02:40 Hold it in there for, you know, 30 seconds or so.

02:45 Try and wring out all the excess water.

02:50 Find yourself a flat surface.

02:54 I need a little more room on this one.

03:00 Now we're ready.

03:01 Padded on both sides ready to apply.

03:04 Have my ace wraps.

03:09 Kind of the bony prominences we worry about for a short leg splint include the fibular head, the perineal nerve wraps posteriorly to it.

03:17 Definitely don't want any pressure over that area.

03:20 We'll have both malleoli, the lateral malleolus, the medial malleolus.

03:25 We definitely don't want any specific hard fiberglass material over those areas as well.

03:29 So now we're ready to apply.

03:32 I always like to start distal first.

03:36 Because we can always adjust proximal.

03:37 As we have the splint applied now, now we're ready to apply the ace wrap to protect and have some compression for the splint.

03:50 You want it to be tight but not overly tight.

03:55 You don't want to cause what they have called a compartment syndrome.

04:00 But it's got to be snug enough to where the fiberglass material conforms to the fracture.

04:25 I got my piece of tape ready.

04:32 Proximal fibular clear, nothing around there, medial malleoli, lateral malleoli, everything, no pressure is noted.