Splint Care

What is a splint?

A splint is a support that protects body parts after you are injured or have surgery. A splint is sometimes called a half-cast because it does not wrap around an entire body area like a cast does. A splint is used to decrease pain and stop or limit movement so you can heal. Splints can also stretch or mold tissues to help keep or improve your range of motion (joint movement). A joint is the area where two or more bones meet, such as your shoulder or ankle. Unlike casts, caregivers can easily adjust a splint if you have swelling or pain after an injury. Splints help keep your injured body area in its normal position to prevent further injury. Having a splint placed can help your bones and tissues heal as they should, so you can move better.

What kind of splint might I have?

Splints come in many shapes and sizes. A splint can be as simple as buddy taping (fingers taped together) for a finger injury. Other splints are large, and can support your hips or thighs. Some splints are pre-made of plastic or fabric. The fit of these pre-made splints can be adjusted with hooks and loop straps, buckles, or laces. Pre-made splints can be taken off to wash, rest your injury, or do exercises that caregivers suggest. Other kinds of splints are made of hard plaster or fiberglass. Hard splints stay on all the time. Caregivers may adjust or remove your hard splint as you heal. Ask your caregiver for more information about the different kinds of splints.

What ways can splinting be done?

• Static splinting: Static splints prevent you from moving an injured area. You might get a static splint right after an injury to relieve pain and reduce swelling. Depending on your injury, you may get a cast, after the swelling goes down.
  
  
• Dynamic splinting: Caregivers may switch you to a dynamic splint as you begin to heal. Dynamic splints allow you to have increased movement of the joints that have had limited range of motion.
  
  
• Serial splinting: During serial splinting, caregivers change your splint once a week, for six weeks or more. Serial splinting allows more movement in your joint with each splint change.

Why might I need a splint?

Ask your caregiver for more information about these and other injuries or conditions often treated with splints:

• Fractures: A fracture occurs when you have one or more breaks in your bones. A static splint can help keep the broken ends of your bones together, preventing movement as they heal.
  
  
• Sprains: A sprain occurs when the muscles, tendons, or ligaments around a joint tear or twist past their normal position. Tendons are tough tissues that connect muscle to bone. Ligaments are tissues that connect bone to bone. A static splint can decrease pain and prevent movement while tears in your tendons, ligaments, and muscles heal. When healing begins, dynamic splints help prevent problems from contractures, and help keep your range of motion. Contractures occur when your tissues, such as muscles and tendons, tighten and shorten from lack of movement.
  
  
• Strains: A strain can occur when you have a muscle injury. Static splints can reduce pain from the injury and movement. As you heal, dynamic splints may be used to help you keep your range of motion.
  
  
• Joint dislocations: A joint dislocation occurs when the bones in a joint move out of their normal place. Once the bones are put back in place, a splint may be needed. A splint holds your bones in place as the ligaments and tendons heal.
  
  
• Surgery: Splints can reduce pain and protect the joint after surgery to repair your tendons and ligaments. As you heal, a dynamic splint can help you move the joint safely. Other splints stretch and mold your tissues so you can move better after surgery.
  
  
• Chronic conditions that cause pain and swelling: A splint may help reduce pain, swelling, and stiffness from chronic (long-term) conditions, such as arthritis or carpal tunnel syndrome. Splints can also stop movement in a joint while inflamed (swollen) tendons, and the tissues around them, heal.
  
  
• Burns: After a severe burn, scars form and tissues get shorter. The shortened tissues change the way a burned area works and looks. Splints can stretch your tissues to help you keep your range of motion. Splints can also protect the area as it heals and after skin grafts or other surgeries.

How is hard splinting done?

• You will sit or lie down on a table or bed. Caregivers will check your blood flow, movement, and feeling around the injury. Any skin or tissue injuries may be treated first. Before your splint is put on, you may get medicine to help decrease your pain. A sheet may be put over you to help protect your clothes while caregivers apply your splint.
  
  
• First, a tube of fabric, called a stockinette, may be put over your skin, around your injury. You may not have a stockinette if caregivers expect a lot of swelling to occur. The stockinette helps protect your skin and will make the edges of your splint smooth. Caregivers then place your injured body area in the correct position, and wrap your injury with 2 to 3 layers of padding. You will get extra padding over bony areas, such as your ankle or elbow. Layers of the wet plaster or fiberglass sheets are applied and smoothed over the padding. The edges of the stockinette and padding are then folded back over the hard splint to smooth the edges. You may have one more layer of padding added before caregivers wrap and secure an elastic bandage around your splint.
  
  
• An x-ray may be done to check your bone placement after you get your splint. This is normally done if you have a bone fracture or joint dislocation. Caregivers will check your blood flow, skin temperature, and feeling around the injury after your splint is on. You may get a sling, for an arm or shoulder injury, to decrease your arm movement. You may be given crutches, for a leg or ankle injury, for support when standing or walking.

How long will I wear a splint?

You will need to see your caregiver for a follow-up visit 1 to 2 weeks after you get a splint. Wear your splint as long as your caregiver tells you to. Most splints are worn from days to weeks, depending on your injury. Many fractures can take 4 to 8 weeks to heal. Serial splints, which stretch your tissues over time, may be worn longer. Some splints can be taken off at certain times of the day. Ask your caregiver when, or if, your splint should be adjusted or removed.

How do I care for my splint?

• Do wait for your hard splint to harden completely. If you have a splint on your leg and will be walking, fiberglass can support your weight after about 30 minutes. Your caregiver may tell you to wait up to three days before walking on a plaster splint.
  
  
• Do check your splint, and the skin around it, each day. Check your splint for damage, such as cracks and breaks. Check your skin for redness, increased swelling, and sores.
  
  
• Do keep your splint dry. Before you bathe or shower, wrap your hard splint with two layers of plastic, then put a plastic bag over it. Keep the plastic bag tightly sealed. You can also ask your caregiver about waterproof shields. Do not put your hard splint in water , even with a plastic bag over it. A wet splint can make your skin itchy, and may lead to infection.
  
  
• Do keep your splint clean. Keep dirt out of your splint.
  
  
• Do loosen the elastic bandage around your splint if it feels too tight.
  
  
• Do not put powders or deodorants inside your splint, because they can dry your skin and increase itching.
  
  
• Do not try to scratch the skin inside your hard splint with sharp objects, such as coat hangers. Sharp objects can break off inside your splint or hurt your skin.
  
  
• Do not pull the padding out of your splint. The padding inside your splint protects your skin. You may get severe (very bad) sores on your skin if you take out the padding.

How do I treat pain and swelling after I get my splint?

Caregivers may suggest the following to prevent pain and swelling from your injury:

• Pain medicines: Your caregiver may give you medicine to decrease or take away your pain. Your caregiver may also tell you to take acetaminophen and nonsteroidal anti-inflammatory medicine (NSAIDs) to decrease pain. These medicines can be bought with or without a doctor’s order. These medicines can cause stomach bleeding, liver problems, or kidney problems. Always read and follow the directions on the medicine label before using these medicines.
  
  
• Rest and elevation: Elevate (raise) the splinted area by keeping it above the level of your heart for 1 to 3 days. You may lie back in a bed or chair and put pillows under an injured leg or foot. Use pillows to prop up an injured arm or hand. You can loosely tie a pillow to your splint to elevate it while you sleep. Ask your caregiver how long you should elevate your splinted area.
  
  
• Ice: Ice causes blood vessels to constrict (get small), which helps decrease swelling and pain. Put crushed ice in a plastic bag and cover it with a towel. Put the ice pack on your injury for 30 minutes at a time, for the first two days. Use the ice as often as your caregiver says you should.
  
  
• Gentle movement: Wiggle your fingers and toes often. Gentle movement while you rest helps reduce stiffness and swelling.

What are the risks of splinting?

• Your splint may feel tight until the swelling from your injury decreases. A tight splint may be painful, and can limit blood flow to your injury. Pressure from the splint may cause your injured area to feel numb (loss of feeling) or tingly. The skin under your splint may become dry, itchy, or infected. You may get painful sores on the skin under the splint. Your splinted joint may feel stiff. You may develop contractures that change the way your injured area works and looks. Your risk for these problems increases the longer you have to wear the splint.
  
  
• Sometimes a hard splint can burn your skin from the heat the splint creates as it dries. You may develop compartment syndrome, which is swelling that becomes so severe that it blocks blood flow to your injury. Compartment syndrome can cause severe pain and long-term damage to your muscles and nerves. Without treatment for an injury, such as a fracture or sprain, your bones and tissues may not heal properly. If you have open sores from an injury, they may get deeper and bigger. You may have long-term damage to your muscles and other tissues and lose feeling in the area. Your sores may get infected. The infection can spread to your bones, blood, and other parts of your body. This kind of infection is very serious, and can be life-threatening. Talk with your caregiver if you have questions or concerns about your injury or treatment.

Where can I get more information about my injury?

Contact the following:

• National Institute of Arthritis and Musculoskeletal and Skin Disease
  Information Clearinghouse
  National Institutes of Health
  1 AMS Circle
  Bethesda , MD 20892-3675
  Phone: 1- 301 - 495-4484
  Phone: 1- 877 - 226-4267
  Web Address: http://www.niams.nih.gov
  

When should I call my caregiver?

Call your caregiver if:

• Your hard splint gets wet or is damaged.
  
  
• You have a fever (high body temperature).
  
  
• Your splint is tight, or feels tighter than before.
  
  
• You have itchy, dry skin under your splint that is getting worse.
  
  
• The skin under your splint is red or you have a new sore.
  
  
• There is a bad smell coming from your splint.

When should I seek care immediately?

Seek care immediately or call 911 if:

• Your pain is increasing.
  
  
• Your fingers or toes are numb (lose feeling) or tingling.
  
  
• You feel burning or stinging around your injury.
  
  
• Your nails, fingers, or toes turn pale (decreased color), blue, or gray, and feel cold.
  
  
• You have new or increased trouble moving your fingers or toes.
  
  
• Your swelling gets worse. You may see more swelling in your fingers or toes below your splint.
  
  
• The skin under your splint is bleeding or leaking pus.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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