Thumb Spica Splinting

00:07 Hello, welcome to the Skills on Point intro to splinting course.

00:11 In this video, we'll be demonstrating a Thumb Spica Splint with a 3M Scotchcast.

00:18 Here's our splint material.

00:20 My name is Michael Karg.

00:21 I'm a physician assistant.

00:22 I work in orthopedic trauma.

00:24 Here today some of the reasons why we might use a thumb spica splint, possible scaphoid fracture, base of the thumb fractures, questionable finger fractures at the base of the thumb.

00:37 Any one of those injuries can be safely splinted with a short on thumb spica.

00:45 One thing I like to kind of reiterate on every talk, have your splint material, everything ready to go.

00:51 Once we open the package, the splint material starts to cure and harden, so you gotta be ready to go.

00:56 When we dip it in the water that's when it finishes off the curing process.

01:00 So for a short arm thumb spica splint using fiberglass, we have our materials ready.

01:06 We have our stockinette.

01:08 We're going to measure out the length of the patient's arm.

01:12 And we have our stockinette ready, we're going to apply that thumb hole.

01:20 Again, be cognizant of the distal palmar crease, you want the patient to be able to use their other fingers while we have the thumb locked up.

01:29 Still do some function with those fingers.

01:31 We have our web roll ready which we're going to put on the thumb.

01:35 You can also use stockinette for this part if you have that in your office.

01:40 Web role is just a cotton type padding.

01:44 You always want to apply it fairly tight.

01:50 And cover up the thumb.

01:53 One of the key things you want to do is kind of leave the very tip of the thumb open so you can check for capillary refill.

02:07 So there we are.

02:10 Now we're about ready to apply the splint.

02:13 Splint material ready to open.

02:17 I am going to cut a little bit off this.

02:20 Both sides are padded to protect the patient's skin.

02:24 We're going to shorten this up a little bit.

02:28 Always have a nice pair of scissors with you, you don't want to be scrounge around for that.

02:34 Have your splint material, dip it or immerse it in water, give it a chance to soak in a little bit.

02:43 Bring it out, try and get all the excess water out.

02:50 Put it on a flat surface, flatten it out.

02:55 And now we are ready to apply this.

02:58 So a thumb based thumb spica splint, what we're trying to do is immobilize the CMC joint down here, so that the patient can't move the thumb, but it's still able to move all the other fingers.

03:10 So as you can see right there, patient's tip of the thumb is fine.

03:15 What I'm going to do actually since I've cut that I'm going to cut the end of this off.

03:20 So there's no of these hard spikes at the end.

03:23 So what I'm going to do is kind of dig in there.

03:27 And you'll see that in my lecture part as well.

03:29 You don't want to leave that to abrade the patient's skin.

03:36 That's a good thing about having everything ready.

03:38 As you can see now, you don't see any of those hard potential spikes for the patient.

03:44 So we have our thumb spica splint.

03:49 Ace wrap right here.

03:51 I have a very nice patient who was helping me hold the splint that's great.

03:55 Other times I might have somebody helping me like a cast tech or nurse, someone who just hold the splint while I'm wrapping the ace wrap.

04:14 And then we have our 2 inch to wrap around the thumb.

04:27 Try and have them in a neutral position.

04:42 And then we have clips.

04:48 Clips somewhere.

04:50 It might fell away.

04:52 There is your thumb spica splint.

04:55 Tip of the fingers so I could check your capillary refill.

04:57 She's able to flex her fingers, can be a very functional splint till the patient can be seen by a specialist.

05:04 Thank you.