Ulnar Gutter Splinting

00:06 Hi there, welcome to Skills on Point intro to splinting course.

00:11 In this video, we'll be demonstrating how to perform an Ulnar Gutter Splint with a 3M Scotchcast.

00:18 My name is Michael Karg.

00:18 I'm a physician assistant who works in orthopedic trauma.

00:22 Working today for skills on point to demonstrate how to appropriately apply in ulnar gutter type splint using this cast material or splint material.

00:30 What we're going to do today, like I say in most of my videos have all of your supplies ready.

00:35 So I have my water basin, have my ace wraps, stockinette, web roll, scissors, gloves, and splinting material.

00:46 So for ulnar gutters, these are used for boxer fractures of the wrist, any metacarpal fracture, distal ulnar fractures, and on their gutter type splint is basically based on the on the aspect of this of the forearm.

01:04 What we want to be cognizant of is the ulnar styloid as you can see is very prominent so we don't want to have any hard splint fiberglass material overlying that area.

01:15 And then you have the base of your in the heads of your metacarpals that we have to protect as well.

01:21 She has a fifth metacarpal fracture, which we're going to split today.

01:25 So I have all my supplies ready, I have my stockinette cut for the short arm part of this splint.

01:35 Again, identifying the distal palmar crease, so the patient can still be functional.

01:40 And not too long here proximately.

01:45 Web roll, what we're going to do is so before this fifth metacarpal fracture, I always like to have something in between the fingers, because obviously this is going to get hot and lacerated.

01:58 And what this does is it protects the fingers from that laceration.

02:02 And then from there, I'm going to prep the area with this 2 inch web role.

02:07 They also have to in stock and for this purpose.

02:11 For today's show, we're going to kind of show this web roll application.

02:17 So I have some in between the fingers.

02:21 Fingertips are still able to be visualized, I can check for cap refill, and so we're ready to go.

02:28 Next we have our splint material.

02:35 Measure out.

02:37 We're going to cut it down a little bit because we've measured it to be a little bit shorter.

02:49 And then I learned from my last mistake that I'm going to cut inside this a little bit, so that this doesn't have any contact with the patient's skin.

02:59 This gets really warm so you don't want to have this directly in contact with a patient's skin.

03:06 Immerse the splint material in water.

03:10 Hold it in there for about 30 seconds.

03:14 Wring it out.

03:16 Have a nice flat area to get out the excess water.

03:22 And now we're ready to apply this splint, have my ace wraps right here.

03:27 This position is great for holding a fifth metacarpal fracture reduced.

03:34 Sometimes it depends on how angulated the fracture is but it is variable depending on the type of fracture.

03:40 But what we're going to do is apply this splint.

03:42 I know it hurt, the head of metacarpals on her styloid a very well padded area.

03:52 A kind of conform it to the ulnar aspect of the forearm, and then I'm ready to apply the ace wrap.

04:19 And then we have our 2 inches.

04:24 We'll go with a base wrap, and then we'll come up top here.

04:47 Tape.

04:50 Now, we're all set.

04:52 And now I can hold this and mold this to however I want this fracture positioned until it gets hardened about you know 5-10 minutes so...

05:00 as you can see tip of the fingers visualized distal palmar crease, she's able to use whatever fingers I left her and everything else looks great here.